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13% of parents of children who died of cancer considered requesting hastened death for their child: this was more likely if their child was in pain
  1. Kathleen Meert
  1. Children's Hospital of Michigan/Wayne State University, Detroit, Michigan, USA
  1. Correspondence to Kathleen Meert
    Critical Care Medicine, Children's Hospital of Michigan, 3901 Beaubien, Detroit, MI 48201, USA; kmeert{at}med.wayne.edu

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Scope of the problem

Approximately 25,000 children between 1 and 19 years of age die annually in the USA.1 Cancer accounts for about 8% of these deaths and is the second leading cause of death after traumatic injury in this age group. Death from cancer is often preceded by a period of intense suffering with symptoms of pain, dyspnea, fatigue, and progressive loss of functional status. Intensive symptom management is a crucial aspect of end-of-life care for these patients.2

Treating symptoms versus hastening death

Analgesics and sedatives are commonly used to manage symptoms at end of life. Although these agents may reduce respiratory drive, when …

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