Processo de tomada de decisão ética em fim de vida em terapia intensiva pediátrica: uma revisão integrativa

Abstract

Although it is uncommon for children to die in the pediatric intensive care unit (PICU), the majority of infant deaths in the most developed countries occur in the PICU, often following decisions to limit life support. Limiting life support (LLS) refers to the appropriateness and/or proportionality of the treatment offered, with the aim of avoiding excessive procedures and therapies with no prospect of success. The aim of this dissertation is to analyze, from the perspective of the ethics of care, the decision-making process of pediatric intensive care physicians in limiting life support in pediatrics (LLSP). This study consisted of an integrative review of national and international scientific literature, and criteria were established for the selection of articles. Data from the articles were analyzed using content analysis according to the thematic analysis technique. The results allowed us to identify the definition of LLS, the main ethical dilemmas faced when making decisions about LLS, the criteria used to indicate this practice in pediatric ICUs, the factors that influence this decision-making process, the medical team's view of LLS, and the consequences of these decisions. Based on the results of this study, we can see that the ethics of care is well suited as a theoretical-practical reference in decision-making procedures in PICUs, not only in cases related to LLSP.