Ethics-Pediatric End of Life

Question 1

How many kids die each year? What are the common causes of death?

Answer 1

50,000 in US each year
Trauma
Congenital and perinatal conditions
Extreme prematurity
Heritable disorders
Acquired illness, neoplasms

Question 2

What types of end of life discussions do you need to have with pediatric patients with progressive disease?

Answer 2

DNR
Withdrawal of support
aggressive symptom management only?

Question 3

T/F Palliative care is the same as end of life or hospice care.

Answer 3

False. It is not the same. Different guidelines for children than for adults. Time of death is difficult to predict.

Question 4

When does palliative care begin & end?

Answer 4

can begin at diagnosis & end at cure or death

**even after death, there should be palliative care for grieving family members.

Question 5

Describe the integrative palliative & curative model.

Answer 5

initially cure or aggressive treatment is goal w/ consideration of the patient’s quality of life.
there are also goals to relieve specific symptoms, such as pain.
eventually, you may have to address end of life issues.

Question 6

T/F Foregoing life-sustaining treatment is not the same as making a choice to hasten the death of a child.

Answer 6

true. doctrine of double effect

Question 7

T/F Physicians often give inadequate pain medication out of fear of hastening death.

Answer 7

True.

Question 8

Who might be a part of the palliative care team?

Answer 8

Child, family, parents’ employers, teachers, school staff, health care professionals, nurses, chaplains, bereavement counselors, social workers, primary care physicians, and consultants.

Question 9

Should you have open & honest conversations with pediatric patients about their imminent death?

Answer 9

YEs, it is important to be open & honest.

Question 10

What is respite care?

Answer 10

Provision of care to an ill child by qualified caregivers other than family members

Question 11

T/F You should not allow parents to hold their children after death.

Answer 11

False. You should allow them to do this-a part of the grieving process.

Question 12

What support is there for caregivers?

Answer 12

paid funeral leave
routine counseling
remembrance ceremonies

Question 13

T/F Physicians, medical students, & nurses all experience grief the same following a patient death.

Answer 13

False. they experience it differently. Need support in the process.