Executive summarys4
Background considerationss6
  The extent of withholding and withdrawal of LST in paediatric practices6
  The legal frameworks7
    The child and young adults8
    Parental Responsibilitys8
    The role of the courts in end-of-life decision makings9
    Best interestss9
    Quality of life and legal decisionss9
    Withdrawing treatments9
  The ethical frameworks10
    Fundamental considerationss10
    The interests of the childs10
    Parental discretion responsibilities, rights, duties and powers10
    Parental interests, wishes and professional dutiess11
    Involving childrens11
    Children with disabilitiess11
    Transition to adult servicess12
    Axioms on which to base best practices12
The process of decision makings13
  Practical considerations; substantial issues in decision makings13
    To withhold, to withdraw or to limit?s13
    Dealing with uncertaintys13
    Situations in which it is appropriate to limit treatments13
    Spectrum of decisions and parental discretions14
  Practical aspects of end-of-life care: responsibilities, treatments that may be limited, appropriate or permissible actionss15
    Clinical responsibilities of the healthcare teams15
    The range of treatments that may be withdrawns15
    Cardiopulmonary resuscitations15
    Clinically assisted nutrition and hydrations16
    Muscle relaxants and end-of-life cares16
    Palliative cares16
    Organ donations17
  Practical aspects of decision makings17
    The basis of decision making by teamss17
    Obtaining second opinionss17
    Resource considerationss18
    Communication as part of decision makings18
    Resolution of different opinionss19
    Medical inputs19
  The healthcare teams20
  Key goals in the provision of bereavement supports20
Future practicalitiess21
  Clinical ethics servicess21
Appendix 1: Suggested bereavement resourcess23