Palliative care and euthanasia in terminally ill children



Even in this day and age, palliative care and euthanasia are still highly sensitive topics, much more so when it comes to terminally ill children. A study by researchers at the Dana Farber Cancer Institute interviewed parents who experienced loss of a child to cancer and brought into the open some revealing aspects about these issues. The study revealed that some parents would prefer to spare their children from pain even it means hastening death.

According to senior author Dr. Joanne Wolfe who is head of the Division of Pediatric Palliative Care at Dana-Farber and Director of Palliative Care at Children’s Hospital Boston:

“The problem is that conversations about these family worries may not always happen. Parents may not have the opportunity to express these feelings and considerations, and as clinicians, we may not be adequately enabling sufficient opportunity for them to talk about their concerns.”

The researchers interviewed parents of pediatric patients at the Dana-Farber, Children’s Hospital Boston, or Children’s Hospitals and Clinics of St. Paul and Minneapolis, Minn. who died of cancer. The parents were interviewed about their feeling and behaviors before, during, and even up to more than a year after the death of their child. 13% (1 out of 8) thought of euthanasia and considered asking their child’s health care provider of hastening death. However, only 9% had openly discussed the issue with the health professionals. Five parents eventually requested hastening their child’s death to prevent unnecessary pain and but in only three cases was the request granted, carried out by morphine injection.

Parents were also asked to react to hypothetical vignettes and in case of a child being in uncontrollable pain or irreversible coma, 50% of the respondent parents were in favor of hastening death.

In recent years, the field of palliative care has made progress in helping the terminally ill in the final days of their lives. The emotional and psychological impact on the love ones, however, has also to be considered, especially in parents of young children. The researchers admit that there are gaps in providing palliative care to patients and support to the family, partly because this is an aspect of health care that is necessary given priority when it comes to research funding.

Dr. Wolfe continues:

We’ve come a long way, because we have a good palliative and supportive care program for children with cancer. [However], I can never promise that their child will be pain free. We still have quite a way to go in figuring out the best way to ease suffering at the end of life.”

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