In a study of 141 parents whose children have died of cancer, more than 10 percent reported that they considered hastening their child's death, especially if the child was in pain, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The article is one of several in the issue focusing on childhood cancers, and is being published in conjunction with a JAMA theme issue on cancer. The March issues of Archives of Neurology, Archives of Internal Medicine, Archives of Ophthalmology, Archives of Dermatology, Archives of Surgery, Archives of Facial Plastic Surgery and Archives of Otolaryngology-Head & Neck Surgery will also publish articles on this theme.

In one article, Veronica Dussel, M.D., M.P.H., of the Dana Farber Cancer Institute and Children's Hospital, Boston, and colleagues interviewed 141 parents of children who had died of cancer between 1990 and 1999. In addition to discussing their own child's life and death, the parents were asked to respond to a series of vignettes portraying children with end-stage cancer.

A total of 19 of 141 parents (13 percent) reported that they had considered requesting that their children's death be hastened and 9 percent had discussed it. Consideration of hastening death appeared to increase as the child's reported pain increased; about one-third (34 percent) of parents said that they would have considered hastening death had their child been in uncontrollable pain. In response to vignettes, half of parents endorsed hastening death, whereas 94 percent endorsed intensive pain management.

"If physical suffering is identified, our results suggest that parents are willing to have an open discussion about existing options including effective and legal alternatives such as proportionately intensive symptom management and palliative sedation. Desires for hastened death may represent an exit plan to be used if no other alternatives are recognized," the authors conclude. "Attention to pain and suffering and education about intensive symptom management may mitigate consideration of hastening death among parents of children with cancer."

Arch Pediatr Adolesc Med. 2010;164[3]:231-237.

Source
Archives of Pediatrics & Adolescent Medicine