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American Journal of Hospice and Palliative Medicine®
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*Children's Health
*Palliative Care
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The Use of Pediatric Advance Directives: A Tool for Palliative Care Physicians

Susan E. Zinner, MSJ, MHA, JD

School of Public & Environmental Affairs, Indiana University Northwest, Gary, Indiana, szinner{at}iun.edu

Although laws such as the Patient Self-Determination Act encourage individuals to address their end-of-life treatment preferences using advance directives, the wishes of children have traditionally been ignored or, perhaps even worse, overruled. Given that there is a substantial body of research indicating that children are capable of making mature decisions when faced with terminal illness, the author proposes granting minors, especially older minors, the right to participate in making end-of-life decisions. Children who complete advance directives benefit in multiple ways. Adopting this approach could benefit patients by demonstrating respect for patient autonomy and informing parents and providers that the minor may be ready to stop aggressive treatment.

Key Words: palliative care • autonomy • advance directive • consent • cognitive development • adolescents

This version was published on January 1, 2009

American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 6, 427-430 (2009)
DOI: 10.1177/1049909108322294


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