Ethical Decision Making About End-of-life Care Issues by Pediatric Oncologists in Economically Diverse Settings

Citation:

Ana M. Sanchez Varela, Liza-Marie Johnson, Javier R. Kane, Kimberly A. Kasow, Yuri Quintana, April Coan, Ying Yuan, Raymond Barfield, Christopher Church, Micah Hester, and Justin N. Baker. 5/1/2015. “Ethical Decision Making About End-of-life Care Issues by Pediatric Oncologists in Economically Diverse Settings.” J Pediatr Hematol Oncol, 4, Pp. 257-63. Publisher's Version

Abstract:

PURPOSE:

Pediatric cancer represents 1% to 4% of all cancers worldwide, with the majority of diagnoses in developing countries where mortality remains much higher than that in high-income countries. We sought to describe differences in ethical decision-making at the end of life among an international sample of pediatric oncologists practicing in countries with a variety of income levels and resource settings.

METHODS:

Pediatric oncologists subscribing to an educational international oncology Web site were invited to complete a 38-item web-based survey investigating ethical domains related to end-of-life care: level of care, fiduciary responsibility, decision making, and justice.

RESULTS:

Responses were received from 401 physicians in 83 countries, with most respondents practicing in middle-income or high-income countries. Significant differences in attitudes toward ethical issues existed across the national developmental indices.

CONCLUSIONS:

Further education on ethical principles is warranted in pediatric oncology, particularly among oncologists practicing in low-income or middle-income countries.

PubMed PMID: 25887639