Ethical issues in managed and rationed care for children with severe neurological disabilities: a questionnaire survey

The attitudes of pediatric neurosurgeons to managed and rationed carl for c hildren with severe neurological disabilities were surveyed as reflected in responses from International Society for Pediatric Neurosurgery (ISPN) mem bers to a questionnaire. Of 399 ISPN members, 156 (39.1%) responded to the questionnaire. There were 15 questions, which were designed to explore what care is medically indicated, whether all medically indicated care should a lways be provided, and how this care should be managed or rationed. Most re spondents agreed that these patients should receive the same level of medic al care as a normally developing child. However, respondents felt that card iopulmonary resuscitation (CPR) is not indicated if a child is not retrieva ble. Most respondents also felt that provision of care should be influenced by cost. The responses to the questions from ISPN members were compared wi th those from Child Neurology Society (CNS) members.