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PROFESSIONAL ISSUESPediatric end-of-life care found lackingExperts and advocates call for research and coordination of palliative care for children.By Andis Robeznieks, AMNews staff. Aug. 19, 2002. Communicating bad medical news is never easy. And when the bad news involves children, sometimes even the most eloquent medical professionals are at a loss for words. Perhaps the most profound evidence of this is a 1997 survey cited in a new Institute of Medicine report "When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families." In a survey of 122 emergency physicians, more than two-thirds admitted to prolonging resuscitation efforts in order to delay telling parents their child had died, according to researchers at the University of Illinois at Chicago. Poor communication is just one problem cited in the IOM report. It describes how the circumstances behind the nearly 50,000 children who die each year in the United States are often compounded by "needless pain and anxiety." Other problems highlighted in the report include the difficulties in negotiating "this country's fragmented health and social service systems" while engaging in "a constant battle" with health plans that are said to favor invasive procedures, discourage interdisciplinary care and undervalue palliative services. "It is hard to imagine a situation that has a greater imperative for humane caregiving, yet, far too often today, it is not provided," wrote pediatrician Richard E. Behrman, MD, in the report's preface. "It is time to correct this situation. We hope this report will serve as a call to action." The call is not only being made by the parents of dying children, but also by the doctors who treat them. The report cites a 1998 study in which 100% of residents, 90% of attending physicians and 83% of fellows surveyed at one institution said they wanted more support in dealing with death. [...] Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2002 American Medical Association. All rights reserved.
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