Child Neurologists as Health Care Surrogate for Imperiled Children

We explored child neurologists’ attitudes toward taking on the role of health care surrogate for terminally ill children. Physician members of the Child Neurology Society were sent a 16-question survey via email. Of the assumed 1050 recipients, 116 (11%) answered the questionnaire. Most individuals who have been in practice less than 11 years indicated having received formal end-of-life decision-making education either during medical school or residency. Conversely, a minority of participants who have been in practice more than 11 years indicated having received such education. Regardless of years in practice, 54% (n = 61 of 112) of participants would feel at least ‘‘somewhat comfortable’’ independently making life-limiting decisions for imperiled patients. The number increased to 80% if the decision were made within the context of a multidisciplinary team. Taking our data and the experience published by others into consideration, we suggest a method for establishing such a team.