Arch Pediatr Adolesc Med. 2012 Jul 1;166(7):594.
Balancing the Tension: Parental Authority and the Fear of Paternalism in End-of-Life Care: Comment on "Confession"Balancing the Tension.
"In “Confession,”1 Dr Humikowski faces a nearly impossible task: to recommend the withdrawal of a mechanical ventilator from a child with a severe and devastating neurological injury while navigating cultural barriers. Although requesting maternal permission to withdraw the ventilator may appear absurd, some doctors feel obligated to request parental permission, influenced by our Westernized value system that prioritizes respect for parental authority in all medical decision making.2 Yet, this perceived obligation is not ethically or legally justified.
Requiring permission from parents to withdraw life-sustaining therapies is harmful to parents,3 as expressed in this article by Dr Humikowski.1 It “shirks” our duty as physicians and requires parents to take responsibility for the death of their child, a task that is nearly impossible for most parents.3- 4 To relieve this burden, the palliative care literature recommends a goal-oriented approach to communication in end-of-life care.5 - 6 Understanding the goals of the family enables us to provide directive medical recommendations without requiring parents to make nearly impossible decisions."
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