Universally, the death of a child provokes extreme grief. How a child dies may also provoke fundamental moral disagreements—sometimes between parents, among doctors and nurses, even across cultures. Which medical treatments may be justifiably withheld or withdrawn? Who should make such a decision? How much sedation and analgesia is too much for a dying patient? Is pediatric euthanasia ethically justifiable?
In this issue of Archives of Pediatrics and Adolescent Medicine, Vrakking et al1 describe end-of-life decisions for children in the Netherlands between August and December 2001. They report the following: