Health: New advice for doctors on treating critical children

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The Independent Online
Doctors treating desperately ill children sooner or later face a case in which they have to decide whether the treatment is worse than the disease.

Advances in medical technology mean it is now possible to sustain life without foreseeable benefit, causing great suffering to the child and their family. But when is it right to say enough is enough?

On Wednesday, the Royal College of Paediatrics And Child Health will publish the first guidelines for doctors setting out when it may be appropriate to withdraw treatment. The report is understood to outline five situations where this can be considered, including the case of a baby born 17 weeks early weighing little more than one pound. "Weeks of intensive care may save her but with a high risk of severe mental and physical handicap," it says.

Other situations include a ten-year-old with leukaemia not responding to increasingly painful and distressing treatment, and a teenager with the wasting disease, muscular dystrophy, who is not going to survive to adulthood and who develops pneumonia.

Professor Sir Roy Meadow, former president of the college, said the most acute problems arose over very premature babies who could now be saved as a result of medical technology but who might not achieve a "satisfactory" life. "Now everything is possible it raises masses of problems as to whether it is right to do it," he said.

The guidelines follow a series of heart-rending cases in which parents have gone to court to have treatment stopped or to challenge doctors' refusal to continue fighting for their child's life. Last week the parents of Rhys and Charley Daniels who both have Battens disease which causes dementia and blindness, announced they had decided to stop further treatment and let them die at home. The children had suffered enough, they said.

- Jeremy Laurance