744 ‘Allow Me to Decide '! the Dying Child Rights

Abstract

In Israel about 450 children are annually diagnosed with hemato-oncological diseases. About 150 children die every year from cancer. Palliative care for children is provided in different settings, home, hospitals and in “Bet Wiesel”, the supportive care inpatient unit for children which offers various services at different stages of the disease. We believe that the children have basic rights like: right to privacy, autonomy, open communication, confidence and the right to be treated with dignity; in order to prevent anxiety and isolation in the final stages of life, and facilitate successful treatment. Difficult ethical dilemmas are encountered in our daily work such as the right to accept or refuse a certain procedure/treatment that in the past rested entirely with the parents or guardian and not with the minor. Rejection of a minor to a medical procedure creates a conflict of values between the child, parents and health care providers. The law in Israel enables a minor to express his intentions, via the parents and thus to accept or refuse the proposed care plan. The ethical question that arises: Would it be correct if the measure of such rights be defined by the minor's age only? Or by the parents and health care providers who are obligated to protect and preserve the sanctity of the child's life? A “tailor made” care plan is designed based on the child's health condition, wishes and level of understanding considering the parents' expectations and support needs during every decision making process to obtain optimal care.