Ethical Aspects of Nursing Children with Cancer

The care and treatment of children with cancers and malignancies has improved enormously over the last few decades. Some forms of cancers are no longer even considered as life limiting disorders, but simply as serious - but curable illnesses, e.g. Childhood Acute Lymphoblastic Leukaemia (ALL). This medical and nursing progress however has come at a high price.

Today, we are not only concerned with aggressively treating the presenting disease but also ensuring a reasonable long-term quality of life after treatment. Increasingly, as a consequence of aggressively treating children, these individuals are succumbing to secondary cancers - often less treatable than the original cancer! There are also problems with side-affects of treatment and problems with allocating and tracing compatible bone-marrow donors. Finally, the increasing use of experimental drugs not tested on children (and not licensed to be used with children) is also a growing concern. These are but a sample of the many ethical issues faced by the paediatric Oncology team.

In view of these concerns the paediatric Oncology nurse needs to be not only technically and scientifically well educated to work with this population of patients but she needs to be well versed in ethical reasoning and counselling skills - to mediate between the medical team and the family.

This presentation will highlight some of these ethical issues and suggest some remedies for the paediatric Oncology nurse. Cancer nursing can be an area of nursing which is very rewarding but the Oncology nurse needs to be well trained and well prepared for the work and she needs an understanding of health-care ethics and ethical decision-making models. This can only be a bonus and can make all the difference between professional burn-out and work-satisfaction.