Abstract

End of Life decision-making, in pediatrics is critical, imparting a great burden of responsibility on those involved in the process. The decision-making is multidimensional. Pediatricians encounter many ethical concerns during this process. Qualitative, phenomenological research based on indepth interviews of 12 pediatricians from three tertiary care hospitals of Karachi, Pakistan. Data was analyzed using Nvivo 9 software. Six themes were identified, a) Major factors are clinical information and available resource; b)Itis clinically and psychologically challenging; c) Participation of parents is influenced by emotional, socio-economic and religious factors; d) Communication is the most crucial aspect of conflict resolution; e) Institutional policies and expert opinions guide pediatricians f) Clinical Ethics consultation is underutilized in Pakistan. The parents and pediatricians are responsible for decisions aligned to the best interest of children. The role of Pediatricians is critical as they look for the best possible ways to provide care through limited healthcare resources. Parents generally base their views on social and spiritual values. We recommend that healthcare organizations in Pakistan adopt clinical ethics consultation as a source of facilitation and support for these difficult decisions.