Suffering in children at the end of life: Recognizing an ethical duty to palliate

Journal of Clinical Ethics

Volumn 11, Issue 2, 2000, Pages 157-163

  Wolfe, Joanne ^a,b,c  

^a DANA FARBER CANCER INSTITUTE   (United States)

^b BOSTON CHILDREN S HOSPITAL   (United States)

^c Open Society Institute   (Russian Federation)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ATTITUDE TO DEATH; BRAIN TUMOR; CAREGIVER; CASE REPORT; CHILD; DEATH AND EUTHANASIA; ETHICS; FEMALE; HEALTH PERSONNEL ATTITUDE; HUMAN; LEGAL ASPECT; MEDICAL ETHICS; MORALITY; PAIN; PALLIATIVE THERAPY; PRESCHOOL CHILD; PROFESSIONAL PATIENT RELATIONSHIP; STANDARD;

DEATH AND EUTHANASIA; PROFESSIONAL PATIENT RELATIONSHIP;

ATTITUDE OF HEALTH PERSONNEL; ATTITUDE TO DEATH; BRAIN NEOPLASMS; CAREGIVERS; CHILD; CHILD, PRESCHOOL; DOUBLE EFFECT; ETHICS CONSULTATION; ETHICS, MEDICAL; FEMALE; HUMANS; MORALS; PAIN; PALLIATIVE CARE;

EID: 0034208748     PISSN: 10467890     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (21)

1. E.J. Cassell, "Diagnosing Suffering: A Perspective," Annals of Internal Medicine 131 (1999): 531-4, 531.
2. Ibid, 532.
3. K.M. Foley, "Competent Care for the Dying Instead of Physician-Assisted Suicide" (editorial; see comments), New England Journal of Medicine 336 (1997): 54-8; C.S. Cleeland et al., "Pain and Its Treatment in Outpatients with Metastatic Cancer" (see comments), New England Journal of Medicine 330 (1994): 592-6; The SUPPORT Principal Investigators, "A Controlled Trial to Improve Care for Seriously HI Hospitalized Patients: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments" (see comments), Journal of the American Medical Association 274 (1995): 1591-8. A published erratum appears in Journal of the American Medical Association 275, no. 16 (24 April 1996): 1232; G. Frager, "Pediatric Palliative Care: Building the Model, Bridging the Gaps," Journal of Palliative Care 12 (1996): 9-12; M.L. Levin, J.I. Berry, and J. Leiter, "Management of Pain in Terminally HI Patients: Physician Reports of Knowledge, Attitudes, and Behavior," Journal of Pain and Symptom Management 15 (1998): 27-40; J. Lynn et al., "Perceptions by Family Members of the Dying Experience of Older and Seriously 111 Patients" (see comments), Annals of Internal Medicine 126 (1997): 97-106; J. Wolfe et al., "Symptoms and Suffering at the End of Life in Children with Cancer" (see comments), New England Journal of Medicine 342 (2000): 326-33.
4. K.M. Foley, "Competent Care for the Dying Instead of Physician-Assisted Suicide" (editorial; see comments), New England Journal of Medicine 336 (1997): 54-8; C.S. Cleeland et al., "Pain and Its Treatment in Outpatients with Metastatic Cancer" (see comments), New England Journal of Medicine 330 (1994): 592-6; The SUPPORT Principal Investigators, "A Controlled Trial to Improve Care for Seriously HI Hospitalized Patients: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments" (see comments), Journal of the American Medical Association 274 (1995): 1591-8. A published erratum appears in Journal of the American Medical Association 275, no. 16 (24 April 1996): 1232; G. Frager, "Pediatric Palliative Care: Building the Model, Bridging the Gaps," Journal of Palliative Care 12 (1996): 9-12; M.L. Levin, J.I. Berry, and J. Leiter, "Management of Pain in Terminally HI Patients: Physician Reports of Knowledge, Attitudes, and Behavior," Journal of Pain and Symptom Management 15 (1998): 27-40; J. Lynn et al., "Perceptions by Family Members of the Dying Experience of Older and Seriously 111 Patients" (see comments), Annals of Internal Medicine 126 (1997): 97-106; J. Wolfe et al., "Symptoms and Suffering at the End of Life in Children with Cancer" (see comments), New England Journal of Medicine 342 (2000): 326-33.
5. K.M. Foley, "Competent Care for the Dying Instead of Physician-Assisted Suicide" (editorial; see comments), New England Journal of Medicine 336 (1997): 54-8; C.S. Cleeland et al., "Pain and Its Treatment in Outpatients with Metastatic Cancer" (see comments), New England Journal of Medicine 330 (1994): 592-6; The SUPPORT Principal Investigators, "A Controlled Trial to Improve Care for Seriously HI Hospitalized Patients: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments" (see comments), Journal of the American Medical Association 274 (1995): 1591-8. A published erratum appears in Journal of the American Medical Association 275, no. 16 (24 April 1996): 1232; G. Frager, "Pediatric Palliative Care: Building the Model, Bridging the Gaps," Journal of Palliative Care 12 (1996): 9-12; M.L. Levin, J.I. Berry, and J. Leiter, "Management of Pain in Terminally HI Patients: Physician Reports of Knowledge, Attitudes, and Behavior," Journal of Pain and Symptom Management 15 (1998): 27-40; J. Lynn et al., "Perceptions by Family Members of the Dying Experience of Older and Seriously 111 Patients" (see comments), Annals of Internal Medicine 126 (1997): 97-106; J. Wolfe et al., "Symptoms and Suffering at the End of Life in Children with Cancer" (see comments), New England Journal of Medicine 342 (2000): 326-33.
6. K.M. Foley, "Competent Care for the Dying Instead of Physician-Assisted Suicide" (editorial; see comments), New England Journal of Medicine 336 (1997): 54-8; C.S. Cleeland et al., "Pain and Its Treatment in Outpatients with Metastatic Cancer" (see comments), New England Journal of Medicine 330 (1994): 592-6; The SUPPORT Principal Investigators, "A Controlled Trial to Improve Care for Seriously HI Hospitalized Patients: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments" (see comments), Journal of the American Medical Association 274 (1995): 1591-8. A published erratum appears in Journal of the American Medical Association 275, no. 16 (24 April 1996): 1232; G. Frager, "Pediatric Palliative Care: Building the Model, Bridging the Gaps," Journal of Palliative Care 12 (1996): 9-12; M.L. Levin, J.I. Berry, and J. Leiter, "Management of Pain in Terminally HI Patients: Physician Reports of Knowledge, Attitudes, and Behavior," Journal of Pain and Symptom Management 15 (1998): 27-40; J. Lynn et al., "Perceptions by Family Members of the Dying Experience of Older and Seriously 111 Patients" (see comments), Annals of Internal Medicine 126 (1997): 97-106; J. Wolfe et al., "Symptoms and Suffering at the End of Life in Children with Cancer" (see comments), New England Journal of Medicine 342 (2000): 326-33.
7. K.M. Foley, "Competent Care for the Dying Instead of Physician-Assisted Suicide" (editorial; see comments), New England Journal of Medicine 336 (1997): 54-8; C.S. Cleeland et al., "Pain and Its Treatment in Outpatients with Metastatic Cancer" (see comments), New England Journal of Medicine 330 (1994): 592-6; The SUPPORT Principal Investigators, "A Controlled Trial to Improve Care for Seriously HI Hospitalized Patients: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments" (see comments), Journal of the American Medical Association 274 (1995): 1591-8. A published erratum appears in Journal of the American Medical Association 275, no. 16 (24 April 1996): 1232; G. Frager, "Pediatric Palliative Care: Building the Model, Bridging the Gaps," Journal of Palliative Care 12 (1996): 9-12; M.L. Levin, J.I. Berry, and J. Leiter, "Management of Pain in Terminally HI Patients: Physician Reports of Knowledge, Attitudes, and Behavior," Journal of Pain and Symptom Management 15 (1998): 27-40; J. Lynn et al., "Perceptions by Family Members of the Dying Experience of Older and Seriously 111 Patients" (see comments), Annals of Internal Medicine 126 (1997): 97-106; J. Wolfe et al., "Symptoms and Suffering at the End of Life in Children with Cancer" (see comments), New England Journal of Medicine 342 (2000): 326-33.
8. K.M. Foley, "Competent Care for the Dying Instead of Physician-Assisted Suicide" (editorial; see comments), New England Journal of Medicine 336 (1997): 54-8; C.S. Cleeland et al., "Pain and Its Treatment in Outpatients with Metastatic Cancer" (see comments), New England Journal of Medicine 330 (1994): 592-6; The SUPPORT Principal Investigators, "A Controlled Trial to Improve Care for Seriously HI Hospitalized Patients: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments" (see comments), Journal of the American Medical Association 274 (1995): 1591-8. A published erratum appears in Journal of the American Medical Association 275, no. 16 (24 April 1996): 1232; G. Frager, "Pediatric Palliative Care: Building the Model, Bridging the Gaps," Journal of Palliative Care 12 (1996): 9-12; M.L. Levin, J.I. Berry, and J. Leiter, "Management of Pain in Terminally HI Patients: Physician Reports of Knowledge, Attitudes, and Behavior," Journal of Pain and Symptom Management 15 (1998): 27-40; J. Lynn et al., "Perceptions by Family Members of the Dying Experience of Older and Seriously 111 Patients" (see comments), Annals of Internal Medicine 126 (1997): 97-106; J. Wolfe et al., "Symptoms and Suffering at the End of Life in Children with Cancer" (see comments), New England Journal of Medicine 342 (2000): 326-33.
9. K.M. Foley, "Competent Care for the Dying Instead of Physician-Assisted Suicide" (editorial; see comments), New England Journal of Medicine 336 (1997): 54-8; C.S. Cleeland et al., "Pain and Its Treatment in Outpatients with Metastatic Cancer" (see comments), New England Journal of Medicine 330 (1994): 592-6; The SUPPORT Principal Investigators, "A Controlled Trial to Improve Care for Seriously HI Hospitalized Patients: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments" (see comments), Journal of the American Medical Association 274 (1995): 1591-8. A published erratum appears in Journal of the American Medical Association 275, no. 16 (24 April 1996): 1232; G. Frager, "Pediatric Palliative Care: Building the Model, Bridging the Gaps," Journal of Palliative Care 12 (1996): 9-12; M.L. Levin, J.I. Berry, and J. Leiter, "Management of Pain in Terminally HI Patients: Physician Reports of Knowledge, Attitudes, and Behavior," Journal of Pain and Symptom Management 15 (1998): 27-40; J. Lynn et al., "Perceptions by Family Members of the Dying Experience of Older and Seriously 111 Patients" (see comments), Annals of Internal Medicine 126 (1997): 97-106; J. Wolfe et al., "Symptoms and Suffering at the End of Life in Children with Cancer" (see comments), New England Journal of Medicine 342 (2000): 326-33.
10. K.M. Foley, "Competent Care for the Dying Instead of Physician-Assisted Suicide" (editorial; see comments), New England Journal of Medicine 336 (1997): 54-8; C.S. Cleeland et al., "Pain and Its Treatment in Outpatients with Metastatic Cancer" (see comments), New England Journal of Medicine 330 (1994): 592-6; The SUPPORT Principal Investigators, "A Controlled Trial to Improve Care for Seriously HI Hospitalized Patients: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments" (see comments), Journal of the American Medical Association 274 (1995): 1591-8. A published erratum appears in Journal of the American Medical Association 275, no. 16 (24 April 1996): 1232; G. Frager, "Pediatric Palliative Care: Building the Model, Bridging the Gaps," Journal of Palliative Care 12 (1996): 9-12; M.L. Levin, J.I. Berry, and J. Leiter, "Management of Pain in Terminally HI Patients: Physician Reports of Knowledge, Attitudes, and Behavior," Journal of Pain and Symptom Management 15 (1998): 27-40; J. Lynn et al., "Perceptions by Family Members of the Dying Experience of Older and Seriously 111 Patients" (see comments), Annals of Internal Medicine 126 (1997): 97-106; J. Wolfe et al., "Symptoms and Suffering at the End of Life in Children with Cancer" (see comments), New England Journal of Medicine 342 (2000): 326-33.
11. W.G. Bartholome, "A New Understanding of Consent in Pediatric Practice: Consent, Parental Permission, and Child Assent," Pediatric Annals 18 (1989): 262-5.
12. J. Levin et al., Social Problems: Causes, Consequences, Interventions (Los Angeles: Roxbury, 2000); H. Wallace, Family Violence: Legal, Social and Medical Perspectives (Boston: Allyn & Bacon, 1996).
13. J. Levin et al., Social Problems: Causes, Consequences, Interventions (Los Angeles: Roxbury, 2000); H. Wallace, Family Violence: Legal, Social and Medical Perspectives (Boston: Allyn & Bacon, 1996).
14. Cleeland et al., see note 3 above; Lynn et al., see note 3 above; L.C. Hanson, M. Danis, and J. Garrett, "What Is Wrong with End-of-Life Care? Opinions of Bereaved Family Members," Journal of the American Geriatric Society 45 (1997): 1339-44.
15. Lynn et al., see note 3 above.
16. Wolfe et al., see note 3 above.
17. S.H. Wanzer et al., "The Physician's Responsibility Toward Hopelessly 111 Patients: A Second Look" (see comments), New England Journal of Medicine 320 (1989): 844-9; M.L. Buchan and S.W. Tolle, "Pain Relief for Dying Persons: Dealing with Physicians' Fears and Concerns," The Journal of Clinical Ethics 6, no. 1 (spring 1995): 53-61; M. Angell, "The Quality of Mercy" (editorial), New England Journal of Medicine 306 (1982): 98-9; R.K. Portenoy and N. Coyle, "Controversies in the Long-Term Management of Analgesic Therapy in Patients with Advanced Cancer," Journal of Palliative Care? (1991): 13-24; J.M.Ingham and K.M. Foley, "Pain and the Barriers to Its Relief at the End of Life: A Lesson for Improving End of Life Health Care," Hospice Journal 13 (1998): 89-100.
18. S.H. Wanzer et al., "The Physician's Responsibility Toward Hopelessly 111 Patients: A Second Look" (see comments), New England Journal of Medicine 320 (1989): 844-9; M.L. Buchan and S.W. Tolle, "Pain Relief for Dying Persons: Dealing with Physicians' Fears and Concerns," The Journal of Clinical Ethics 6, no. 1 (spring 1995): 53-61; M. Angell, "The Quality of Mercy" (editorial), New England Journal of Medicine 306 (1982): 98-9; R.K. Portenoy and N. Coyle, "Controversies in the Long-Term Management of Analgesic Therapy in Patients with Advanced Cancer," Journal of Palliative Care? (1991): 13-24; J.M.Ingham and K.M. Foley, "Pain and the Barriers to Its Relief at the End of Life: A Lesson for Improving End of Life Health Care," Hospice Journal 13 (1998): 89-100.
19. S.H. Wanzer et al., "The Physician's Responsibility Toward Hopelessly 111 Patients: A Second Look" (see comments), New England Journal of Medicine 320 (1989): 844-9; M.L. Buchan and S.W. Tolle, "Pain Relief for Dying Persons: Dealing with Physicians' Fears and Concerns," The Journal of Clinical Ethics 6, no. 1 (spring 1995): 53-61; M. Angell, "The Quality of Mercy" (editorial), New England Journal of Medicine 306 (1982): 98-9; R.K. Portenoy and N. Coyle, "Controversies in the Long-Term Management of Analgesic Therapy in Patients with Advanced Cancer," Journal of Palliative Care? (1991): 13-24; J.M.Ingham and K.M. Foley, "Pain and the Barriers to Its Relief at the End of Life: A Lesson for Improving End of Life Health Care," Hospice Journal 13 (1998): 89-100.
20. S.H. Wanzer et al., "The Physician's Responsibility Toward Hopelessly 111 Patients: A Second Look" (see comments), New England Journal of Medicine 320 (1989): 844-9; M.L. Buchan and S.W. Tolle, "Pain Relief for Dying Persons: Dealing with Physicians' Fears and Concerns," The Journal of Clinical Ethics 6, no. 1 (spring 1995): 53-61; M. Angell, "The Quality of Mercy" (editorial), New England Journal of Medicine 306 (1982): 98-9; R.K. Portenoy and N. Coyle, "Controversies in the Long-Term Management of Analgesic Therapy in Patients with Advanced Cancer," Journal of Palliative Care? (1991): 13-24; J.M.Ingham and K.M. Foley, "Pain and the Barriers to Its Relief at the End of Life: A Lesson for Improving End of Life Health Care," Hospice Journal 13 (1998): 89-100.
21. S.H. Wanzer et al., "The Physician's Responsibility Toward Hopelessly 111 Patients: A Second Look" (see comments), New England Journal of Medicine 320 (1989): 844-9; M.L. Buchan and S.W. Tolle, "Pain Relief for Dying Persons: Dealing with Physicians' Fears and Concerns," The Journal of Clinical Ethics 6, no. 1 (spring 1995): 53-61; M. Angell, "The Quality of Mercy" (editorial), New England Journal of Medicine 306 (1982): 98-9; R.K. Portenoy and N. Coyle, "Controversies in the Long-Term Management of Analgesic Therapy in Patients with Advanced Cancer," Journal of Palliative Care? (1991): 13-24; J.M.Ingham and K.M. Foley, "Pain and the Barriers to Its Relief at the End of Life: A Lesson for Improving End of Life Health Care," Hospice Journal 13 (1998): 89-100.