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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 the intended use is to treat pain and agitation in dying patients, the beneficial effects outweigh the potential risks.3 The intentional administration of drugs specifically to hasten death (ie, …
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