Advance care planning for paediatric patients

Question 1

What is the aim of pediatric health care providers?

Answer 1

“to add life to the child’s years, not simply years to the child’s life”

Question 2

What is advance care planning?

Answer 2

Broadly encompasses both short-term and long-term health care goals and treatments. It may include drafting of formal advance directives, which specify what treatments will or will not be provided to the patient.

Question 3

What is palliative care?

Answer 3

Care that focuses on relief of suffering, quality of living and dying, and is not limited to end-of-life care

Question 4

What is the legislation regarding age of consent and advance directives?

Answer 4

BC, Nova Scotia, Yukon, Nunavut, NWT 19yo
Alberta 18yo
Saskatchewan, Manitoba, Ontario, New Brunswick, PEI, Newfoundland 16yo
Quebec 14yo

Question 5

What is the age of majority in Canada?

Answer 5

BC, New Brunswick, Nova Scotia, Nfld, Yukon, NWT, Nunavut 19yo
Alberta, Manitoba, Quebec, 18yo
PEI 16yo
Ontario no age specified

Question 6

What are the CPS recommendations?

Answer 6

1. advance care planning should be standard of care
2. HCP should initiate the discussion and not wait for family to ask
3. discussions should occur early and regularly during treatment course
4. obtain and document wishes regarding emergency and life-sustaining therapies
5. palliative care should be provided as an adjunct in children with severe chronic conditions with shortened LE
6. pediatric palliative care professionals should be involved early
7. pediatricians should advocate for uniform legislation across Canada on advance directives for minors