A New Holistic-Evolutive Approach to Pediatric Palliative Care

This book illustrates why a holistic approach is important in Pediatric Palliative Care (PPC). Readers will learn this approach has a “horizontal” axis, featuring the patients’ mental and physical needs, as well as their environments. It has also a “vertical axis”: the evolutionary changes of the patients throughout their development and their illness, their aspirations and fears. An evolutionary (or dynamic) approach is mandatory. Each child/parent has a different experience of illness and a different path to recovery that is influenced by their age, gender, culture, but also by the state of their grief. To take care of them, we need to know the state of the subjects we are dealing with throughout their evolution in age (children) and in sorrow (both children and parents). Jung’s and Piaget’ schemes will be of support. This book also helps caregivers to know what ethics is. It teaches a new insight on the word “ethics”: not a series of principles or norms, but an approach based on humanistic virtues. Two criteria will be proposed to this aim: an ethics based on the refusal of inauthentic behaviors (or those behaviors that are copies of animals or machines) and a new criterion that even children have some ethical duties (not based on rules, but on naturally acceptance that their sight is modulated by the presence of their parents and friends). This ethical approach is explained to caregivers in a practical mode, ready for clinical exigencies. This book is also unique because it demonstrates that PPC also involves the true care of caregivers. It will explain how to approach, measure and overcome caregivers’ burn-out. Special attention is devoted to the approach to babies’ and children’s pharmacological and non-pharmacological analgesia and sedation. Pain assessment methods will be illustrated, as well as the development of a PPC web on the territory. This text includes perinatal and neonatal PPC. The book will be of valuable support to all those intensivists, pediatricians, nurses, psychologists, physiotherapists and healthcare professionals working in PPC units.