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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry

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Minerva Pediatrica 2014 August;66(4):313-22

language: Italian

Refraining from futile medical treatment in clinical practice. Directives of the Polish Pediatric Society

Glusiec W., Sak J., Pawlikowski J.

Department of Ethics and Human Philosophy, Medical University of Lublin, Lublin, Poland


The continuous development of medicine increases the possibility of sustaining life functions, which frequently leads to prolonging the patient’s agony or exposing him/her to unnecessary suffering. The application of some medical procedures, technical equipment and pharmacological measures that prolong the process of dying in terminally ill children may be a sign of therapeutic obstinacy. Such actions are not an outcome of concern for the welfare of young patients and violate their dignity. In the interest of incurable and terminally ill children and considering the needs of physicians who have to make difficult clinical decisions, the Polish Pediatric Society (PPS) ratified the guidelines concerning abandoning and withdrawal of overzealous therapy. The objective of this article was to present the Italian medical society, Polish rules for refraining from overzealous therapy in pediatrics. The commentary to the Directive include the remarks on the dubious concept of “therapeutic obstinacy”. Following fragments of the article characterize Polish ideas on terminally ill children’s rights, the current situation of these children in medical care, and the origins and character of the document approved by the PPS. The complementation of the commentary are remarks made by a team of experts that develop guidelines which apply to specific clinical problems associated with the care of terminally ill children. This article is yet another voice in the wide debate on the moral imperative of refraining from therapeutic obstinacy in medical practice.

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