ABSTRACT
Parents who have experienced the death of a child from cancer have unique bereavement needs. This study evaluated the possibility of instituting a home-based bereavement visit from the oncology team following a child's death. Parents completed a brief anonymous questionnaire measuring preferences regarding visit logistics and content. The majority (84%) of the 31 participants agreed that a home-based bereavement program is desirable. Qualitative analysis of parental comments revealed common themes including processing grief, practical suggestions for visit, recognition of individual differences, perceived risks and benefits of visit, connections with medical staff, and unmet needs for support. In conclusion, a home visit program may satisfy needs for additional support while alleviating barriers to other types of bereavement care.
Subject(s)
Attitude to Death , Bereavement , Neoplasms/psychology , Parents/psychology , Professional-Family Relations , Social Support , Spirituality , Adaptation, Psychological , Adolescent , Adult , Anecdotes as Topic , Child , Child, Preschool , Female , Grief , Humans , Infant , Male , Middle Aged , Parent-Child Relations , Surveys and Questionnaires , Young AdultSubject(s)
Cardiopulmonary Resuscitation/ethics , Emergency Medical Services/ethics , Heart Defects, Congenital/therapy , Hernias, Diaphragmatic, Congenital , Prenatal Diagnosis/ethics , Resuscitation Orders/ethics , Choice Behavior/ethics , Communication , Deception , Female , Heart Defects, Congenital/diagnosis , Humans , Infant, Newborn , Intensive Care Units, Neonatal/ethics , Life Support Care/ethics , Male , Paternalism/ethics , Pregnancy , Professional-Family Relations/ethics , United StatesABSTRACT
The increasing survival of adolescents with cancer, achieved through intensive therapy, is often associated with sterility. For most teenagers, the ability to have biological children is psychologically and socially important. Methods of preserving fertility, some standard and other experimental, have proliferated, but their use raises ethical issues. This review poses three hypothetical cases, describes the preservation methods, and identifies and analyzes the ethical issues. The discussion asks what needs to be told, who decides what to do, when can a pediatrician refuse to follow a family's choice, and what is the pediatrician's role as advocate for adolescents.
