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Paediatric palliative care and paediatric euthanasia: clarifying a moral continuum.
Chantal Y Joren1, A A Eduard Verhagen2, John D Lantos3
1Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
The Lancet. Child & Adolescent Health
|May 13, 2026
Summary
Paediatric palliative care and paediatric euthanasia both aim to reduce suffering in children with life-limiting conditions. These end-of-life care approaches are viewed as points on a continuum, sharing values of compassion and respect for the child.
Area of Science:
- Medical Ethics
- Pediatric End-of-Life Care
Background:
- Paediatric palliative care and euthanasia address suffering in children with life-limiting conditions.
- Differing ethical frameworks guide permissible interventions in each approach.
Purpose of the Study:
- To explore the complex relationship between paediatric palliative care and paediatric euthanasia.
- To analyze the ethical underpinnings and international variations in these end-of-life care strategies.
Main Methods:
- Comparative analysis of ethical doctrines (e.g., doctrine of double effect).
- Examination of international policies and legal approaches to end-of-life care for children.
- Argumentative viewpoint synthesizing ethical values.
Main Results:
- Both paediatric palliative care and euthanasia share goals of alleviating suffering.
- Interventions differ: palliative care allows withdrawal of treatment and palliative sedation; euthanasia permits interventions with the intent to hasten death.
- International policies vary, with some permitting lethal injections while others prohibit them, often relying on the doctrine of double effect or child's best interests.
Conclusions:
- Paediatric palliative care and euthanasia are not moral opposites but exist on a continuum of ethically motivated responses to suffering.
- Shared values of compassion, proportionality, and respect for child's interests underpin both approaches.
- Recognizing this continuum can inform ethical decision-making in pediatric end-of-life care.
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