Swedish Intensive Care Physicians' Attitudes Towards Withholding or Withdrawing Life‐Sustaining Treatment in Critically Ill Children

Background Decisions to withhold or withdraw life‐sustaining treatments for critically ill children are challenging. This study aims to identify Swedish intensivists' attitudes, values and experiences towards the decision‐making process concerning withholding or withdrawal of life‐sustaining treatment in critically ill children. Methods The nine intensive care units in Sweden that treated more than 10 children for more than 48 h during 2023 were approached. A web‐based questionnaire on attitudes and experiences on end‐of‐life decision‐making in critically ill children was distributed to the 360 physicians employed at the above‐mentioned intensive care units. The results were analysed descriptively. Results Fifty‐five answers were retrieved. The participating physicians were experienced, 93% having personal experience with end‐of‐life decision‐making in children. The main findings were that the child's wishes were considered important or very important by 93% of respondents. The guardians' wishes were considered important or very important by 82% of respondents. Seventy‐three percent of physicians considered it ethically acceptable to withdraw life‐sustaining treatment against the patients' and guardians' wishes. To continue life‐sustaining treatment without the patient's and guardian's consent was considered ethically acceptable by 26% of participants. Conclusions This study demonstrated that Swedish intensivists share common attitudes and values regarding most issues related to end‐of‐life decisions in critically ill children. However, there is variability in attitudes concerning patients' and guardians' wishes. Further studies concerning end‐of‐life decisions in critically ill children within a Nordic context are warranted. Editorial Comment This survey study presents a sampling of views on pediatric intensive care withholding or withdrawing of treatment and from specialist physicians in one Nordic country.