Jim’s Take

Sad, sad story. This JAMA Oncology article (http://oncology.jamanetwork.com/article.aspx?articleid=2383144) talks about kids’ and adolescents’ end of life care with cancer. 22% went to the ER in the last 30 days of life; 22% had ICU treatment in the last 30 days.

For adults the percentages are 4%.

Adults and doctors choose not to have heroic measures performed on them when they know the end is near. 90% of doctors say they would forgo aggressive treatment if terminally ill.

Why do we force our kids to go through it, then? I’ve got to believe that it’s the parents calling the shots, and I believe they have to be driven by guilt and hope and fear of loss.

Guilty because if they refuse treatment they feel they’ll deny their children a chance at life. Hope because what parent WOULDN’T hope for her child’s recovery, even against staggering odds. And fear of loss because what parent couldn’t stare into the abyss of separation they know faces them if this bundle of love, to whom they’ve devoted their entire existence for the lifespan of the child, is taken away.

And yet … think about it. They force on this child, who is unknowing and unable to make his or her own decision, intolerable pain and suffering. The child would surely fare batter in hospice care at home. Hospice it to make the last days as comfortable as they possibly can be. Yet the parents, on whom this helpless child depends, take away the opportunity to have that last little bit of respite.

So sad for everyone involved. I’m really sorry I saw the article because it is truly depressing. Sorry to burden you with it.

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