“Take Out This Thing”: A Teen’s Decision About Removal of a Gastrostomy Tube

Author:

Gutiérrez Hazel M.1,Nakashima Yuri2,Derrington Sabrina3,Lantos John D.4

Affiliation:

1. Pediatric Palliative Care Service, National Children’s Hospital, San José, Costa Rica;

2. Department of Pediatrics, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Mexico;

3. Department of Pediatrics, Feinberg School of Medicine, Northwestern University and Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois; and

4. Bioethics Center, Children’s Mercy Hospital, Kansas City, Missouri

Abstract

Medical decision-making in children is not a static process. In pediatrics, parents and health professionals actively participate in clinical decision-making. They always consider what is in the child’s best interest and sometimes weigh that against other considerations. As children get older, the level of participation in this process may change according to their own cognitive development and maturity level. In this article, we present a case of an adolescent with a life-limiting condition at the end of life. He wants to participate in his health management and speak for himself. He does not always prefer interventions that his parents think are best. Health care practitioners must include mature minors in the decision-making process and be willing to listen to their voices.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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