title: Exhaust All Measures: Ethical Issues in Pediatric End-of-Life Care.
abstract: The death of a child may have a profound impact on parents, family members, and health care providers who provided care for the child. Unique challenges are faced by parents of seriously ill children as they must serve as the legal authority for health care decisions of children under age 18, although the child's wishes must also be considered. Social workers must balance core social work values, bioethical values, and psychosocial issues presented by such situations. While studies have been conducted with physicians and nurses regarding ethical issues in pediatric end-of-life care settings, little is known about how social workers experience these conflicts. This article utilizes two vignettes to illustrate potential ethical issues in this setting and applies the National Association of Social Workers Standards for Palliative and End of Life Care (NASW, 2004 ) to explore options for their resolution. These vignettes provide descriptions of possible reactions in this setting and can be used as a basis for further exploration of ethics in pediatric end-of-life care from a social work perspective.
authors.affiliation: a Arizona State University School of Social Work , Phoenix , Arizona , USA.
authors.forename: Kara J
authors.initials: KJ
authors.lastname: Thieleman
authors.affiliation: b Saint Louis University School of Social Work , St. Louis , Missouri , USA.
authors.forename: Cara
authors.initials: C
authors.lastname: Wallace
authors.affiliation: c University of Texas at Arlington School of Social Work , Arlington , Texas , USA.
authors.forename: Andrea N
authors.initials: AN
authors.lastname: Cimino
authors.affiliation: d Department of Social Work , University of Texas at San Antonio , San Antonio , Texas , USA.
authors.forename: Heidi A
authors.initials: HA
authors.lastname: Rueda
mesh_terms: D003657:Decision Making; D005190:Family; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D010290:Parents / Q000523:psychology*; D010372:Pediatrics; D011368:Professional-Family Relations; D000068217:Social Workers / Q000523:psychology*; D013727:Terminal Care / Q000941:ethics* / Q000523:psychology* / Q000592:standards; D028761:Withholding Treatment / Q000941:ethics
keywords: Death and dying; ethics; pediatric end-of-life care