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Paediatric Palliative Care in Clinical Practice: Ethical Issues in Advance Care Planning and End-of-Life Decisions

Anamarija Meglič1, Ajda Lisec2

  • 1Pediatric Palliative Care Team, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia.

Journal of Evaluation in Clinical Practice
|April 21, 2025
PubMed

Insights

Ethical challenges in paediatric palliative care (PPC) end-of-life (EOL) decisions arise from communication and differing opinions. Improved communication and teamwork are vital for optimal care.

Area of Science:

  • Medical Ethics
  • Paediatric Palliative Care

Background:

  • Examines ethical challenges in paediatric palliative care (PPC) end-of-life (EOL) decision-making for children with life-limiting conditions.
  • Highlights the complexities faced by healthcare teams in these sensitive situations.

Purpose of the Study:

  • To assess PPC team attitudes towards ethical issues in EOL care.
  • To propose innovative solutions for managing these ethical dilemmas.

Main Methods:

  • Anonymous questionnaire survey of 10 PPC team members at University Children's Hospital Ljubljana in 2022.
  • Data analysis using Mann-Whitney U test to evaluate ethical concerns in communication, decision-making, and patient characteristics.

Main Results:

  • Ethical issues frequently arise from challenges in coordinating treatment opinions, potentially excluding children from PPC.
  • Communication, differing healthcare provider opinions, and patient-specific factors were identified as key ethical concerns.
  • Emphasizes the critical role of effective communication and shared decision-making.

Conclusions:

  • Addressing ethical complexities in paediatric EOL care necessitates strong communication and interdisciplinary collaboration.
  • Poor communication is linked to the exclusion of children from PPC services.
  • Innovative strategies and continuous training are essential for enhancing care quality for children and families.
Abstract

Keywords:
advance care planningchildrenend‐of‐life decisionethicspalliative care

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