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when doctors and families disagree: new advice on managing conflict when treating very sick children

The number of children living with serious illness is rising as medical technology allows us to sustain their lives.  There is also a lot of information available online to desperate parents about unproven treatments, which increases the likelihood of conflict in paediatric practice.

Disagreement between doctors and parents over how to treat a sick child remains rare.  But as in the recent cases of Charlie Gard and Alfie Evans it can have profound effects on the family and the health professionals involved.

Why do such situations arise?  Does the distress for families facing the loss of a child mean disagreement is sometimes inevitable?  Can consensus be reached when parents and doctors want to act in the child’s best interests – but disagree on what those interests are? 

Achieving Consensus: advice for paediatricians and other health professionals on prevention, recognition and management of conflict in paediatric practice is produced by the Royal College of Paediatrics and Child Health (RCPCH) and was published in Archives of Disease in Childhood


Dr Mike Linney, Registrar of the Royal College of Paediatrics and Child Health (RCPCH) and Consultant Paediatrician at Western Sussex Hospitals NHS Foundation Trust

Prof Dominic Wilkinson, Director of Medical Ethics at the Oxford Uehiro Centre for Practical Ethics, University of Oxford

Dr Peter-Marc Fortune, Consultant Paediatric Intensivist at Manchester University NHS Foundation Trust and President of the Paediatric Intensive Care Society

Sarah Barclay, Founder of the Medical Mediation Foundation

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