Ethical decision making about end-of-life care issues by pediatric oncologists in economically diverse settings.


Journal Article

PURPOSE: Pediatric cancer represents 1% to 4% of all cancers worldwide, with the majority of diagnoses in developing countries where mortality remains much higher than that in high-income countries. We sought to describe differences in ethical decision-making at the end of life among an international sample of pediatric oncologists practicing in countries with a variety of income levels and resource settings. METHODS: Pediatric oncologists subscribing to an educational international oncology Web site were invited to complete a 38-item web-based survey investigating ethical domains related to end-of-life care: level of care, fiduciary responsibility, decision making, and justice. RESULTS: Responses were received from 401 physicians in 83 countries, with most respondents practicing in middle-income or high-income countries. Significant differences in attitudes toward ethical issues existed across the national developmental indices. CONCLUSIONS: Further education on ethical principles is warranted in pediatric oncology, particularly among oncologists practicing in low-income or middle-income countries.

Full Text

Duke Authors

Cited Authors

  • Sanchez Varela, AM; Johnson, L-M; Kane, JR; Kasow, KA; Quintana, Y; Coan, A; Yuan, Y; Barfield, R; Church, C; Hester, M; Baker, JN

Published Date

  • May 2015

Published In

Volume / Issue

  • 37 / 4

Start / End Page

  • 257 - 263

PubMed ID

  • 25887639

Pubmed Central ID

  • 25887639

Electronic International Standard Serial Number (EISSN)

  • 1536-3678

International Standard Serial Number (ISSN)

  • 1077-4114

Digital Object Identifier (DOI)

  • 10.1097/mph.0000000000000271


  • eng