Children with cancer in India: An ethical framework for practice

Area of Science:

• Pediatric Oncology
• Bioethics
• Healthcare Policy

Background:

• Childhood cancer is a leading non-communicable disease cause of death in Indian children aged 5-14.
• Ethical concerns exist in pediatric cancer care in India, with a lack of established clinical practice standards.
• Children experience distress when excluded from cancer care decisions.

Purpose of the Study:

• To develop an ethical framework for guiding clinical practice in childhood cancer care in India.
• To address identified ethical concerns, including communication, symptom management, and equity.

Main Methods:

• Normative analysis of documents concerning healthcare providers and children in India.
• Stakeholder consultations with childhood cancer survivors, parents, and clinicians.

Main Results:

• The ethical framework consists of twelve key ethical principles.
• It outlines corresponding challenges and implications for clinical practice.
• The framework addresses communication issues, inadequate symptom management, and inequities due to poverty.

Conclusions:

• Integrating this ethical framework into clinical practice can prevent or mitigate ethical concerns in childhood cancer care in India.
• The framework provides guidance for improving the ethical quality of care for children with cancer.