Parents seeking assisted death for children: doctors

TORONTO — For most people, medically assisted death likely conjures up the image of an adult with a terminal illness seeking to end their suffering. But surveys released this week show pediatricians are increasingly being approached by parents of gravely ill children about aid in dying, even though the act is prohibited for those under 18.

The surveys by the Canadian Paediatric Society (CPS) found children’s doctors reported having more exploratory discussions about assisted death at the behest of mature minors or from parents of young children with life-limiting conditions. In some cases, physicians received explicit requests for aid in dying, with more than half of those for babies under a year old.

While the idea of taking a child’s life might seem unthinkable, doctors say there are a number of grievous conditions in which distraught parents might consider that option to avoid prolonging their youngster’s pain and suffering.

“I certainly have had inquiries from both patients and parents whose child has advanced cancer,” Dr. Dawn Davies, a pediatric palliative care physician at the Stollery Children’s Hospital in Edmonton, said Thursday.

“When we think about palliative care and end of life for children, everybody automatically goes to cancer, but that would actually only be about 20 per cent of my practice,” added Davies, chair of the CPS’s bioethics committee, who coauthored the surveys.

But she said there are many other devastating diseases and conditions that will truncate a child’s life that could prompt parents to inquire about assisted death, starting with those affecting newborns.

“Sometimes, there’s something that we call multiple congenital anomalies. So that can be when you have malformations of many parts of the child’s body, some of which may be painful and for which we know the life expectancy will be limited,” said Davies, explaining that such malformations can affect many systems, from the eyes and brain to the heart, lungs and digestive tract.

“And in those situations, sometimes parents will say: ‘Why does my child need to suffer through to the time of their natural death when we know it’s going to happen?’”

Other babies may be born with severe birth asphyxia that has left them permanently comatose but still breathing.

“They will continue to live, but have no capacity to interact with their environment or be self-aware in the future, as far as we can tell.”