Disagreements in the care of critically ill children

Conclusions

Some of the damaging effects of protracted disagreements between parents and healthcare staff about the care and treatment of critically ill children could be avoided if those disagreements were prevented from developing in the first place, or if they were more quickly resolved. The reasons why disagreements develop and continue are wide ranging, but common themes include: communication issues; differing perspectives, beliefs and values that lead them to disagree on, for example, what kind of risks justifiably could be taken; feelings of powerlessness for both parents and staff; and delays in seeking resolution interventions when a disagreement arises. The wider social and cultural context is also likely to be playing a part in the development and continuation of disagreements. Whilst there will always be instances where parents and healthcare staff disagree, there is scope for policy makers and others to do more to support the creation of healthcare environments that foster good, collaborative relationships between parents and healthcare staff.