When is that moment? The criteria for withdrawing treatment from terminally ill children – in the context of the recurring problem of “passive euthanasia”

Introduction and objective: The article aims to formulate criteria determining the right moment to discontinue life support to a terminally ill child at the end of life. The argument refers to two standards guiding critical decision-making: medical futility and the patient’s best interests. When a child demonstrates discernment, account must also be taken of their reasoning. The deterioration of a child’s health, which precedes the decision to stop further therapeutic efforts, is a clinical condition that immediately precedes torment that can only lead to death, or a situation of complete and definitive exclusion of positive perception and feeling. Materials and methods: The case review covers the specificity of birth in conditions of extreme prematurity, with lethal malformations and with neurodegenerative diseases. Results: This study shows that it is possible to draw a line between lawful consent to the death of a patient and unlawful passive euthanasia. Conclusions: The individual quality of life perceived by the child in question is crucial. In the final phase of terminal disease, there is no medical or moral reason for pain and suffering. Nor is there support for vital functions in a state of deep collapse caused by irreversible brain damage. The insistence of parents to continue such care is more a question of satisfying their own emotional needs and can be judged as a violation of the child’s right to die in peace and dignity.