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Communicating Prognosis at Diagnosis and Relapse or Progression

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Ethical Issues in Pediatric Hematology/Oncology

Abstract

Communication is the most common procedure in medicine and is a vital component of care in pediatric oncology. A significant body of evidence exists that can guide the conversations between pediatric oncology clinicians and patients and their families. Unique to the field of pediatrics in general is the triangular relationship that exists between the physician, the patient, and the patient’s parents, which requires special consideration when discussing communication. It must be recognized that although substantial data underpin the beneficial impact of clear, compassionate, and honest communication to both parents and in an age-appropriate manner, to children, these conversations are not easy. We cannot diminish the emotions that permeate conversations surrounding poor prognosis or relapse of disease; but this chapter serves to guide discussions with a goal to improve care of patients and their families. While the majority of evidence for honest communication comes from studies in adults, here we will review relevant data as it relates to pediatric oncology followed by how to apply this in pediatric oncology practice.

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Author information

Authors and Affiliations

  1. Pediatric Melanoma Program, Division of Pediatric Hematology/Oncology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Brittani K. Seynnaeve

  2. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Brittani K. Seynnaeve, Scott H. Maurer & Robert M. Arnold

  3. Division of Palliative Medicine and Supportive Care, Division of Pediatric Hematology/Oncology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Scott H. Maurer

  4. Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Pittsburgh, PA, USA

    Robert M. Arnold

Authors
  1. Brittani K. Seynnaeve
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  2. Scott H. Maurer
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  3. Robert M. Arnold
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Correspondence to Scott H. Maurer .

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Editors and Affiliations

  1. Texas Children’s Cancer and Hematology Centers, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA

    Kate A. Mazur

  2. Texas Children’s Cancer and Hematology Centers, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA

    Stacey L. Berg

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Seynnaeve, B.K., Maurer, S.H., Arnold, R.M. (2020). Communicating Prognosis at Diagnosis and Relapse or Progression. In: Mazur, K., Berg, S. (eds) Ethical Issues in Pediatric Hematology/Oncology . Springer, Cham. https://doi.org/10.1007/978-3-030-22684-8_3

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  • DOI: https://doi.org/10.1007/978-3-030-22684-8_3

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