Shared decision-making in pediatric palliative care in the Netherlands

Area of Science:

• Pediatrics
• Palliative Care
• Healthcare Ethics

Background:

• Shared decision-making (SDM) and Advance Care Planning (ACP) are gaining traction in the Netherlands.
• These concepts were largely unknown to Dutch healthcare professionals (HCPs) a decade ago.
• Recent advancements like the Individual Care Plan (ICP) and Dutch Evidence-Based Guideline on Pediatric Palliative Care (DGPPC) have accelerated adoption.

Purpose of the Study:

• To describe the current state of pediatric palliative care in the Netherlands.
• To highlight the recent evolution and increasing adoption of ACP and SDM.
• To discuss the necessary shift from paternalistic to a more collaborative care model.

Main Methods:

• The study provides a narrative overview of the adoption of ACP and SDM in Dutch pediatric palliative care.
• It discusses the influence of recent guidelines and care plans.
• It analyzes the cultural shift required for successful implementation.

Main Results:

• ACP and SDM are rapidly becoming standard practice among Dutch HCPs.
• There is a significant increase in research and practical application of these conversational approaches.
• The integration of ICP and DGPPC has supported this evolution.

Conclusions:

• The Netherlands is experiencing a positive evolution in pediatric palliative care, with a growing emphasis on ACP and SDM.
• A fundamental shift in HCP mindset is crucial for effective implementation, moving towards a more humble and open approach.
• Continued effort is needed to fully integrate these patient- and family-centered practices.