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Towards developing an ethical framework for decision making in long-term ventilation in children

The use of long-term ventilation (LTV) in children is growing in the UK and worldwide. This reflects the improvement in technology to provide LTV, the growing number of indications in which it can be successfully delivered and the acceptability of LTV to families and children. This article discusses the various considerations to be made when deciding to initiate or continue LTV, describes the process that should be followed, as decided by a consensus of experienced physicians, and outlines the options available for resolution of conflict around LTV decision making.