Parents of Dying Children Consider Death Over Suffering

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(March 2) -- Thirteen percent of a group of parents who were faced with the imminent death of their child considered hastening the process, and a handful acknowledged that they asked doctors to use fatal doses of medication to end the child's suffering for good, according to a revealing new study.

The findings are from a survey of 141 parents whose children had died of cancer a year earlier at hospitals in Boston and Minnesota. The results were published in this week's Archives of Pediatric & Adolescent Medicine.

Nine percent of the parents had actually discussed hastening death with a medical caregiver, and parents of five children said they "explicitly requested" it from a doctor. Three sets of parents said the doctor involved had agreed to inject the children with a lethal dose of morphine.

When asked to consider scenarios retrospectively, 34 percent of the parents said they would have contemplated hastening their child's death if the child had suffered from "uncontrollable pain." Fifty percent supported the right of other parents to make the same choice.

Mercy killings are officially opposed by the American Pediatric Society and most other mainstream medical organizations. But the study's authors don't assume that doctors were committing mercy killings in that handful of cases. Rather, they hypothesize that the parents misinterpreted the doctor's willingness to offer better pain relief as assisted suicide.

The children may have died earlier because of the side effects of heavy doses of painkillers. But their death was still caused by cancer, not euthanasia.

"I have no doubt that in a small number of cases, some physicians might cooperate with a parent's desire to see a child's suffering ended," Dr. Douglas Diekema, a medical ethicist at Seattle Children's Hospital, told The Associated Press. "This might include giving a drug for sedation or pain control that also suppresses the drive to breathe."

And among the parents who admitted to contemplating expedient death, all were motivated by the desire to end their child's pain. That's a subtle, but important, difference, according to doctors reacting to the study.

"Hastening death" is first and foremost about pain relief, with quicker death a potential side effect. Assisted suicide, however, is the explicit provision of drugs meant to end life.

The study doesn't offer answers to the question of coping with a child's passing, or the inevitable pain that children will suffer during a struggle with terminal cancer. But, researchers note, it highlights a need for progressive thinking with regard to the unique situation shared by parents and terminally ill children, and better communication from doctors about options for pain relief.

"Desires for hastened death may represent an exit plan to be used if no other alternatives are recognized," they write. "If physical suffering is identified, our results suggest that parents are willing to have an open discussion about existing options ... such as proportionately intensive symptom management and palliative sedation."

Although the end-of-life debate has been ongoing for years, especially with two states now offering legal options for assisted suicide, this is the first American research to touch specifically on children. Internationally, the Netherlands is the only country where euthanasia is legal for infants and children.

The researchers advocate openness between doctors and struggling parents, but also note that regardless of progress, the situation will never be simple. In addition to parents, doctors need to address their values regarding end-of-life decisions. After interviewing doctors in Oregon, where assisted suicide is legal, the study concluded that "these conversations are highly challenging."

"Finding an equilibrium between their position and their willingness to relieve patient suffering does not come easily," the study said.

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You know...I don't know what to say. I've never known anyone in a situation like that...so I can't even begin to comprehend the thought process for this. They had to have been some extreme cases.

Still... what a sad subject.

I can't even comment or think about this..... I get sooooo emotional about kids.

Ditto. I always had a soft spot...but it got wayyyy worse once I had Wesson. I can't imagine.

Jeannette wrote:Ditto. I always had a soft spot...but it got wayyyy worse once I had Wesson. I can't imagine.

it breaks my heart about all the news stories of children mistreated or hell the stories Kenny tells me of stuff he has seen..... that is why Kenny and I WILL be adopting...... we've decided..... we're going to try to have one more child on our own..... and regardless of turn-out, we'll adopt another one after that...... that way at least we can save one child, and give he/she the love they deserve!

Awwww! I would adopt in a heartbeat...but I don't think Jon would go for it.

He was hardcore against it in minor discussions in the past. I wonder how he'd feel about it now... Especially since THIS baby factory is closed.

Kenny was not keen on the idea at first.... I've always wanted to..... but I'll tell you..... his job and seeing what he has seen has made him do a 180 on that issue!

I can't imagine what he's seen. Lotsa crazies out there...

Jeannette wrote:I can't imagine what he's seen. Lotsa crazies out there...

Well not to go into too many stories...... because they are sad..... but I'll never forget when Mackenzie was about 3 months old..... I woke up in the middle of the night to Kenny sitting on the couch holding Mackenzie and just SOBBING because he had to respond to a call where another 3 month old had died...... I wasn't there, and it still tears me up!!

LaDonna wrote:

Jeannette wrote:I can't imagine what he's seen. Lotsa crazies out there...

Well not to go into too many stories...... because they are sad..... but I'll never forget when Mackenzie was about 3 months old..... I woke up in the middle of the night to Kenny sitting on the couch holding Mackenzie and just SOBBING because he had to respond to a call where another 3 month old had died...... I wasn't there, and it still tears me up!!

That makes me want to cry.

Jeannette wrote:

LaDonna wrote:

Jeannette wrote:I can't imagine what he's seen. Lotsa crazies out there...

Well not to go into too many stories...... because they are sad..... but I'll never forget when Mackenzie was about 3 months old..... I woke up in the middle of the night to Kenny sitting on the couch holding Mackenzie and just SOBBING because he had to respond to a call where another 3 month old had died...... I wasn't there, and it still tears me up!!

That makes me want to cry.

it's horrible!!!