End of life care: Neonates and infants

1. 106. It may be particularly difficult to make a decision on the basis of what is in the best interests of a neonate or infant. If, when considering the benefits, burdens and risks of treatment (including resuscitation and clinically assisted nutrition and hydration) you conclude that, although providing treatment would be likely to prolong life, it would cause pain, or other burdens that would outweigh any benefits and you reach a consensus with the child’s parents and healthcare team that it would be in the child’s best interests to withdraw, or not start the treatment, you may do so. However, in the case of decisions about clinically assisted nutrition and hydration, before you reach a definite decision to withdraw or not to start treatment, you must seek a second opinion (or, if this is not possible, advice) following the guidance at paragraph 121. Whatever decision is made, you must make sure that any distressing symptoms that the child may be experiencing are managed effectively and that the child’s condition is reviewed regularly.