End of life care sedation for children

Curr Opin Support Palliat Care. 2011 Sep;5(3):285-90. doi: 10.1097/SPC.0b013e3283492aba.


Purpose of review: This article is aimed to review updated research on end-of-life care sedation (EOLC-S) for children and aspects surrounding this issue.

Recent findings: Prevalence of EOLC-S for children may vary across countries on account of cultural differences, in terms of settings, legal issues and perceptions about EOLC-S, which lead to variation in patient selection and management. Although home is the preferred place of death for families, research shows hospital settings and ICUs to be the most frequent places where children die. Data on how to define refractory symptoms and update research on drug selection and dosing are lacking. Nature of symptoms at end of life (EOL) is described for cancer patients, but few articles focused on nononcological conditions. Decision making at EOL is commonly discussed with families but children are less frequently involved.

Summary: A thorough search of databases was conducted for articles published in the last year. We found few articles describing EOLC-S as a last resort. But how, when and by whom a symptom is defined as refractory, is not well established. Aggressive symptom management at EOL along with advanced care planning conducted by pediatric palliative care teams could diminish EOLC-S. More research is needed.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Child
  • Child Welfare*
  • Conscious Sedation / ethics
  • Conscious Sedation / methods*
  • Culture
  • Decision Making
  • Humans
  • Palliative Care / ethics
  • Palliative Care / methods*
  • Practice Guidelines as Topic*
  • Quality of Life / psychology
  • Risk Factors
  • Terminal Care / ethics
  • Terminal Care / methods*