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- Tammy I. Kang, MD, MSCE*
- David Munson, MD*
- Jennifer Hwang, MD, MHS*
- Chris Feudtner, MD, PhD, MPH*
- *The Children’s Hospital of Philadelphia, Philadelphia, PA
AUTHOR DISCLOSURE
Drs Kang, Munson, Hwang, and Feudtner have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
- AAP:
- American Academy of Pediatrics
- CCC:
- concurrent care for children
- NICU:
- neonatal intensive care unit
- PPC:
- pediatric palliative care
Practice Gap
The 2013 American Academy of Pediatrics (AAP) Policy Statement “Pediatric Palliative Care and Hospice Care: Commitments, Guidelines, and Recommendations” urges broader integration of palliative care into overall medical care plans not only for terminally ill infants and children but also for those with life-threatening or life-shortening illnesses. Despite supportive federal legislation, the AAP recommendations have not been implemented consistently because of inadequate training, lack of funding, entrenched professional attitudes, and lack of an evidence base for assessments and interventions. To overcome these barriers, pediatric health care clinicians should educate themselves, their patients, their practices, and their health care systems on the benefits of earlier palliative care intervention.
Introduction
During the past decade the field of pediatric palliative care (PPC) has transformed. Palliative care services, once thought to be suitable only for patients in the last stages of life or reserved for patients engaging hospice services, are now being used much more broadly. No longer restricted to just the provision of end-of-life care, palliative care for children is now best understood as encompassing a combination of medical, psychosocial, and spiritual care that enables children with serious, life-threatening illnesses to maximize quality of life while making medical decisions based on the goals and values of the patient and family.
Integrating palliative care into the overall plan of medical care for children with serious illness is a key therapeutic goal. In 2013, the American Academy of Pediatrics (AAP) published a policy statement entitled “Pediatric Palliative Care and Hospice Care: Commitments, Guidelines, and Recommendations” that aimed to promote the welfare of infants and children living with life-threatening or inevitably life-shortening conditions and their …
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In this issue
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- Article
- Practice Gap
- Introduction
- Dispelling the Myth That Palliative Care Is Only for Dying Patients
- Evidence of the Effect of PPC Services
- Integration of Palliative Care With Disease-Directed Therapies
- Pediatric Palliative Care in the NICU
- Case 1: Palliative Care in the NICU
- Pediatric Palliative Care for Children With Progressive illnesses
- Case 2: Palliative Care for Metachromatic Leukodystrophy
- Pediatric Palliative Care for Children With Advanced Cancer
- Case 3: Palliative Care for Advanced Cancer
- Conclusion
- References
- Figures & Data
- Info & Metrics
- Comments
- Quiz