Decision-making and Poor Prognosis: When Death is Silenced by Action

Area of Science:

• Medical Ethics
• Pediatric Oncology
• Palliative Care

Background:

• Hospitals frequently address complex issues like quality of life, end-of-life decisions, and treatment continuation.
• Pediatric oncology settings involve critical choices regarding life-sustaining treatments and care trajectories.

Purpose of the Study:

• To analyze the decision-making process during treatment trajectory shifts in pediatric oncology.
• To explore the transition from curative to palliative care for patients with poor prognoses.
• To understand the dynamics between science, caregivers, and patients in end-of-life care.

Main Methods:

• Ethnographic study conducted in a pediatric hospital's hematology-oncology transplant unit.
• Qualitative analysis of decision-making processes and care transitions.

Main Results:

• Identified challenges and complexities in the decision-making process for treatment changes.
• Observed the shift from disease-directed therapy to palliative care in pediatric oncology.
• Highlighted the crucial interplay between medical professionals, families, and patients.

Conclusions:

• The transition to palliative care in pediatric oncology is a complex, multifaceted process.
• Effective communication and shared decision-making are vital for navigating poor prognoses.
• The patient-caregiver-science relationship is central to sustaining care until the end of life.