Ethical aspects of mechanical resuscitation in achild : Results of an expert workshop within the BMBF project CLAIRE-Children's Automated Intelligent Resuscitation

Abstract

While the use of mechanical resuscitation devices can be considered for adult resuscitation, the European Resuscitation Council guidelines do not yet mention their use for pediatric resuscitation. Only one device has been partially approved for use in children; further pediatric appliances are currently being used off-label. Ethical considerations arising from the use of mechanical resuscitation devices have not yet been presented in astructured way. To elaborate ethical considerations in the development phase of mechanical resuscitation devices for children. Based on several fictitious case reports, an interdisciplinary expert focus group discussion was conducted. This was followed by amoderated discussion, summarizing the results. Guiding principles and research desiderata were formulated using these results as well as existing literature. According to the group of experts, ethical considerations regarding mechanical resuscitation devices in pediatrics predominantly concern the subject of indication and discontinuation criteria. Ethical aspects concerning psychosocial impacts on affected families and intervention teams cannot be generalized and need to be analyzed on acase-by-case basis. The considerations presented regarding the use of mechanical resuscitation devices in the pediatric context, which is still in its developmental stage, could also have practical implications for adult out-of-hospital resuscitation decisions. Concerning ethical aspects of out-of-hospital resuscitation decisions, especially using mechanical resuscitation devices, the need for accompanying empirical research is substantial.