A child with severe intractable epilepsy, profound neurological impairment, and frequent and lengthy admissions to the hospital for repeated and prolonged status epilepticus has an uncertain quality of life. The benefit and ethics of repetitive, aggressive seizure treatment are in question. This case study describes a healthcare team's experience when it was decided to withhold aggressive seizure treatment from a child with severe intractable epilepsy and transition to a palliative care approach. The situation leading up to this decision and the ethical dilemmas, nursing issues and interventions, and lessons learned are reviewed.
Editor's Note: This article was the winning entry in the JNN 2003 Case Study Writing Contest.
Questions or comments about this article may be directed to: Jennifer R. Boyd, MHSc RN CNN(C) MSCN, by phone at 416/813-7738 or by e-mail at firstname.lastname@example.org. She is a clinical nurse specialist in the Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.
Mara Hebbard, RN CNN(C), is a clinical leader on the Neurology, Endocrinology and Metabolic Genetics Unit at the Hospital for Sick Children, Toronto, ON, Canada.
Note: Although this case study is based on a real experience, Zahra S. is a fictitious name used to maintain confidentiality.
© 2004 American Association of Neuroscience Nurses