Integrating ethics and palliative care concepts into pediatric end of life care and decision-making: A changing landscape?

Pediatric palliative medicine in Brazil: an ethical reflection of medical practice

“…In terms of ethical assessment, a series of multidisciplinary meetings and conversations are held involving family, health professionals and the ethics committee, aiming at the best decision on the implementation of the care plan for the patient, so as not to prolong suffering and promote its well-being (18). However, from the study, it was observed that there are often divergences according to the family profile, with regard to religion, be it Catholic Christian, Evangelical Christian, Buddhist, Candomblé, Umbanda, or others that have different ideologies in relation at the end of life and care for the sick, insisting on futile treatments in the view of the medical team that cause greater suffering for the child (8,9). In a study it was found that 98% of children who need palliative care live in Africa, a region with low financial income, predominantly people with black and brown skin, medium to low education, where the sources of information are few or nonexistent, the which hinders the early introduction of palliative care for children.…”

“…The field of pediatric palliative care frequently discusses ethical issues, including prenatal diagnosis, ineffective treatment of children with serious intractable illnesses, and medical negligence. In addition to providing the necessary information for the best treatment options, health professionals have the responsibility to provide patients with all possible treatment methods, however, the limitations of patients and their families must be respected, as the therapeutic choice depends the resources and socioeconomic status, religion and philosophy of patients and their families, as well as policies of related institutions and medical limitations (8,16).…”

“…Race is also another point that draws attention, with black and brown skin colors being highlighted, which we can correlate with the precariousness of education and the low financial standard, which limits access to palliative care, as it is not a treatment for everyone still. Despite its importance, palliative therapy is still limited due to the lack of professionals and adherence to health centers, making it even more inaccessible for this population (8,9).…”