Where the outcome is genuinely uncertain, a time-limited trial offers the child a chance of surviving a potentially reversible crisis while committing both team and family to reassessment against agreed goals at a stated point. If those goals are not met, continued intensive care can then be recognised as prolonging dying rather than treating, and that judgement is made against criteria set in advance rather than in the middle of a crisis. Indefinite escalation reviewed only at cardiac arrest, and immediate withdrawal while the prognosis remains uncertain, are both poorly justified here. Offering the family a stark binary choice shifts an essentially medical judgement onto them, and covertly limiting escalation without telling them is neither honest nor defensible. This framing is discussed in the review of futile therapy protocols in BMC Palliative Care (2025), which notes that for children deteriorating acutely from trauma or malignancy the dilemma is less about stopping treatment than about not prolonging death.