Ethical Decision Making in a Child with Brain Death

Diagnosing brain death in paediatrics is difficult due to emotional, ethical, and legal weightage. This can easily be resolved in a straightforward case following a series of examinations and investigations to confirm that the condition is irreversible. However, in some cases, consideration of religio-cultural, family preferences, and other contextual factors have to be carefully considered. This is due to challenges in ethical decision making whether to continue the treatment or to set for discontinuation of active management. There should be an emphasis on appropriate communication, resolution of conflicts and also a focus on supporting the family and healthcare providers involved in the care of the patient. This is to avoid misunderstanding of information and allowing continuous discussion on the right way forward. Decision making in a complex situation such as paediatric brain death would require ongoing negotiation based on the best interest and beneficence of the medical actions to avoid ongoing suffering for the patient and his/her family.