Shared decision-making about assistive technology for the child with severe neurologic impairment

Pediatr Clin North Am. 2014 Aug;61(4):641-52. doi: 10.1016/j.pcl.2014.04.001. Epub 2014 May 20.


Shared decision-making is a process that helps frame conversations about value-sensitive decisions, such as introduction of assistive technology for children with neurologic impairment. In the shared decision-making model, the health care provider elicits family values relevant to the decision, provides applicable evidence in the context of those values, and collaborates with the family to identify the preferred option. This article outlines clinical, quality of life, and ethical considerations for shared decision-making discussions with families of children with neurologic impairment about gastrostomy tube and tracheostomy tube placement.

Keywords: Children with medical complexity; Gastrostomy; Neurologic impairment; Shared decision-making; Technology dependence; Tracheostomy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Child, Preschool
  • Decision Making*
  • Family
  • Female
  • Gastrostomy / methods*
  • Humans
  • Infant
  • Male
  • Nervous System Diseases / therapy*
  • Physicians
  • Professional-Family Relations*
  • Self-Help Devices*
  • Tracheostomy / methods*