A paper from the Great Ormond Street Hospital for Children in London (Padmanabhan Ramnarayan and colleagues. Journal of Medical Ethics 2007;33:255–60) has raised the question of whether too many children who are terminally ill with chronic conditions are being admitted to intensive care units (ICUs) in the final acute phase of their illness and die there.

A total of 1127 children died in the hospital during a 7-year period (1997–2004). Of …