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She said she could not comment when asked if she knew of any cases occurring at her hospitals, which both were involved in the study.
The third hospital was Children's Hospitals and Clinics of St. Paul, Minn. Dr. Susan Sencer, a cancer specialist there who did not take part in the study, said in a text message that doctors will often tell parents this when dying children are suffering: "'To alleviate pain and suffering we may need to increase the narcotics; increasing the narcotics may result in respiratory depression, which may hasten death,' so that they are aware of the trade-off."
Wolfe said the study highlights the challenges of treating dying children: Parents cannot tolerate seeing their children suffer and do not know about all the legal options for pain relief, which can include sedating children into unconsciousness. Also, many doctors are uncomfortable discussing such issues.
Dr. Melanie Brown, a palliative care specialist at the University of Chicago's Comer Children's Hospital, said she's never had parents ask her to end their child's life, but the general topic has come up.
She said when parents mention the idea, "what they're talking about is ending the pain."
Learning ahead of time about options other than euthanasia can help make these deaths more comfortable for children and their parents, she said.
Dr. Walter Robinson, an ethicist and associate pediatrics professor at Vanderbilt University, said many doctors lack expertise in treating dying children's pain, and many also worry about using opiates including morphine to treat children's pain because there's an unreasonable fear of addiction.
"The lesson we should learn from the paper is the need for expert pain control. That ought to be available in every children's hospital and to every child with a life-limiting illness," Robinson said.
On the Net:
Palliative care: http://www.childrenshospice.org/
Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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