{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:01:45Z","timestamp":1753887705794,"version":"3.41.2"},"reference-count":48,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:p>Decisions to initiate long-term ventilation (LTV) in children with severe neurologic impairment have recently been subject to candidacy determinations by home ventilation teams that exclude patients based on their neurologic status alone. Determinations of whether decisions are inappropriate require careful analysis of specific clinical circumstances and attention to the family\u2019s values. In this Ethics Rounds, we present a case of a previously healthy child who sustained an acute severe anoxic brain injury and was assessed by the medical team to have a high likelihood of remaining minimally conscious or unconscious. It was determined that he was not a candidate for LTV based on the severity of neurologic impairment. The family disagreed and declined withdrawal of ventilatory support. Drawing upon our backgrounds in intensive care, pulmonology, and bioethics, we offer commentary on utilizing a candidacy-based approach for LTV decisions in children with severe neurologic impairment from variable perspectives, including clinical determinations of inappropriate care, ablest biases and discrimination, and obligations to maintain a just process.<\/jats:p>","DOI":"10.1542\/peds.2024-066985","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T08:05:41Z","timestamp":1730880341000},"source":"Crossref","is-referenced-by-count":0,"title":["Candidacy Decisions for Long-term Ventilation"],"prefix":"10.1542","volume":"154","author":[{"given":"Holly Hoa","family":"Vo","sequence":"first","affiliation":[{"name":"aDepartment of Pediatrics, University of Washington School of Medicine, Seattle, Washington"},{"name":"bTreuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children\u2019s Research Institute, Seattle, 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Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgina","family":"Campelia","sequence":"additional","affiliation":[{"name":"bTreuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children\u2019s Research Institute, Seattle, Washington"},{"name":"eDepartment of Bioethics and Humanities, Ethics Consultation Service, University of Washington, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie M.","family":"Henderson","sequence":"additional","affiliation":[{"name":"fDivision of Critical Care Medicine, Department of Pediatrics, Louisiana State University School of Medicine and Children\u2019s Hospital of New Orleans, New Orleans, 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