Children with Chronic Conditions
Clinical Bioethics
Critical Care
Neonatology
Palliative Care
Annie Janvier, MD, PhD (she/her/hers)
Profesor of Pediatrics and Clinical Ethics
University of Montreal
Montréal, Quebec, Canada
Most pediatric and neonatal inpatient deaths occur after a decision has been made to limit or withdraw life-prolonging interventions. The guiding principle in modern bioethics is that decisions should be based on the child’s best interest using a shared decision-making approach. Even in situations where treatment outcomes are uncertain, doctors and parents (and when appropriate pediatric patients) work together to determine whether to pursue life-prolonging treatments or focus on end-of-life care. Key in these discussions are expertise, communication and trust. Skilled practitioners are able to describe various end-of-life scenarios and support parents in the decision-making process by helping determine which choice best supports the family’s values and goals, and which would be the preferred option for a ‘good death’. What are end-of-life options, and should we allow all parental choices even if they are ethically controversial or legally problematic? In this session, researchers in clinical ethics, palliative care and pediatrics from 3 culturally different countries, will explore the range of end-of-life options in pediatric care. How do children die; are there variations of practice in ethical modes of death in “rich countries”? What should parents be told: survival in their center, survival in other centers, the wide variation of practice between centers? Range of end-of-life options in pediatric care, including euthanasia which is legal in 1 country, and ways to speak about death will be discussed. We will debate whether neonatal euthanasia is morally defensible. Finally, the audience will be invited to discuss these complex issues
Speaker: Eduard Verhagen, MD, JD, PhD – University Medical Center Groningen, the Netherlands
Speaker: Annie Janvier, MD, PhD – University of Montreal, CHU Sainte-Justine
Speaker: Alexander A. Kon, MD, HEC-C, FAAP, FCCM – Community Children's and University of Washington School of Medicine