Ventilator-dependent children.

The issue of the ventilator-dependent child is a relatively-new one in Australia. Ventilator-dependent children pose complex and unique ethical, medical, economic and psychological problems. The experience of two Australian centres that are involved with the care of ventilator-dependent children is reported. Most of these children now are being cared for at home. Aspects of home care are outlined. After the initial period, the technical aspects are not a problem for most parents for whom the major issues are the provision and funding of nursing support. The complex ethical issues that are involved are discussed. It is concluded that undergoing ventilation at home rather than in a hospital appears to make the best of an otherwise almost-intolerable situation for ventilator-dependent children, but that much more information is required about the outcome for these children and the long-term psychosocial impact of this treatment.