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Neither the “Devil’s Lettuce” nor a “Miracle Cure:” The Use of Medical Cannabis in the Care of Children and Youth

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Abstract

Lack of guidance and regulation for authorizing medical cannabis for conditions involving the health and neurodevelopment of children is ethically problematic as it promulgates access inequities, risk-benefit inconsistencies, and inadequate consent mechanisms. In two virtual sessions using participatory action research and consensus-building methods, we obtained perspectives of stakeholders on ethics and medical cannabis for children and youth. The sessions focused on the scientific and regulatory landscape of medical cannabis, surrogate decision-making and assent, and the social and political culture of medical cannabis. We found that evidence-gathering and data dissemination, pressures on clinical relationships, and the lack of integration of culturally diverse perspectives and Indigenous knowledges were key areas of concern. Participants emphasized the importance of utilizing adaptive study designs, highlighted the importance of trust-building between clinicians, patients and caregivers, and discussed barriers including historical and ongoing stigmatization of medical cannabis. We conclude that continued public consultation and strength-based research that integrate diverse perspectives are critical steps forward.

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Acknowledgements

Cannabis for Symptom Management in Children with Cancer: Canadian Childhood Cannabinoid Clinical Trials (C4T) Platform (CIHR 707031 ; L. Kelly, Principal Investigator). JI is UBC Distinguished University Scholar. We thank all participants - members of the public and experts - for their time and contributions to this work, and Tracy Brace for her special contribution to the title.

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Authors and Affiliations

  1. Division of Neurology, Department of Medicine, Neuroethics Canada, University of British Columbia, 2211 Westbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada

    Margot Gunning, Ari Rotenberg & Judy Illes

  2. Department of Bioethics, The Hospital for Sick Children, Toronto, Ontario, Canada

    James Anderson

  3. College of Nursing, University of Manitoba, Winnipeg, Canada

    Lynda G. Balneaves

  4. BC Mental Health & Substance Use Services, Provincial Health Services Authority, Vancouver, BC, Canada

    Tracy Brace

  5. Division of Pediatric Hematology/Oncology, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada

    Bruce Crooks

  6. National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Queensland, Australia

    Wayne Hall

  7. Department of Pediatrics and Child Health, Department of Pharmacology and Therapeutics, Faculty of Health Sciences, Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

    Lauren E. Kelly & Zina Zaslawski

  8. Children’s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada

    Lauren E. Kelly

  9. Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    S. Rod Rassekh & Harold Siden

  10. British Columbia Children’s Hospital Research Institute, British Columbia, Vancouver, Canada

    S. Rod Rassekh, Alice Virani & Harold Siden

  11. Robarts Research Institute, University of Western Ontario, London, Ontario, Canada

    Michael Rieder

  12. Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Alice Virani

  13. Canopy Growth Corporation, Smiths Falls, Ontario, Canada

    Mark A Ware

  14. Department of Family Medicine, McGill University, Montreal, Quebec, Canada

    Mark A Ware

  15. George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada

    Zina Zaslawski

  16. Canuck Place Children’s Hospice, Vancouver, British Columbia, Canada

    Harold Siden

Authors
  1. Margot Gunning
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  2. Ari Rotenberg
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  3. James Anderson
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  4. Lynda G. Balneaves
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  5. Tracy Brace
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  6. Bruce Crooks
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  7. Wayne Hall
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  8. Lauren E. Kelly
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  9. S. Rod Rassekh
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  10. Michael Rieder
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  11. Alice Virani
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  12. Mark A Ware
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  13. Zina Zaslawski
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  14. Harold Siden
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  15. Judy Illes
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Corresponding author

Correspondence to Judy Illes.

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Competing Interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, with the exception of MAW who is an employee of Canopy Growth, a Canadian licensed cannabis producer. All authors provided intellectual content, and reviewed and give final approval of the version to be published.

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Alice Virani, Bruce Crooks, James Anderson, Lauren E Kelly, Lynda G. Balneaves, Mark A. Ware, Michael Rieder, S. Rod Rassekh, Tracy Brace, Wayne Hall and Zina Zaslawski are equally contributed to this work.

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Gunning, M., Rotenberg, A., Anderson, J. et al. Neither the “Devil’s Lettuce” nor a “Miracle Cure:” The Use of Medical Cannabis in the Care of Children and Youth. Neuroethics 15, 3 (2022). https://doi.org/10.1007/s12152-022-09478-y

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