Children, the law, and end of life decision-making

A blog post written by Professor Shih-Ning Then

Navigating end of life decision-making can be particularly difficult when there are children with life-limiting conditions involved. The law establishes a broad framework for end of life decision-making for children, with the paramount consideration being the child’s best interests. In treating children at the end of life, health professionals are required to provide clinical care while also handling situations which raise legal issues. For example:

• Managing disagreements that arise with the child or their parents over what medical treatment should be provided.
• Deciding whether a child is Gillick-competent and can consent or refuse consent to their own health care decisions.
• Determining whether consent is required before providing emergency treatment, and if so, from whom that consent is needed.
• Decision-making related to ceasing life-prolonging care or the provision of palliative care.

I will be discussing these situations and the key legal principles you need to know when performing your role at the Australian Paediatric Palliative Care Conference 2022.

Knowing about end of life law concerning children can help clinicians to:

• communicate with children and their families, 
• provide safe, quality, person-centred and compassionate care to children at the end of life, and
• improve their confidence when participating in shared decision-making. 

For more information on end of life law generally, take a look at the End of Life Law for Clinicians (ELLC) training program. This free national training program comprises 12 online modules on fundamental aspects of end of life law and is complimented by End of Life Law in Australia, a website about the law in each state and territory.

We encourage you to explore the following modules:

• Module 7: Examines the law on both parental and competent child decision-making in the context of end of life treatment, along with the law on emergency treatment for children.
• Module 12: Investigates decision-making at the end of life regarding the care of Aboriginal and Torres Strait Islander peoples and families.
• Module 6: Explores the law on providing pain and symptom relief at the end of life, as well as the legal status of palliative sedation and voluntarily discontinuing eating and drinking.
• Module 10: Discusses managing conflict around end of life decision-making.

A comprehensive outline of our training curriculum can be found here.

To undertake the ELLC online modules, register through the training portal.  Certificates of completion and CPD points are available.
 

Professor Shih-Ning Then
Australian Centre for Health Law Research
Faculty of Business and Law, Queensland University of Technology