Palliative expert panel - myths surrounding paediatric palliative research

"What are the biggest myths surrounding research?" was the expert panel focus, moderated by Maria Rugg, former SickKids Advanced Practise Nurse to the Palliative and Bereavement Service, now seconded to the Office of the Chief Coroner of Ontario. The panel comprised of:

Elizabeth Peeters, b.r.a.i.n child president, member of SickKids Research Ethics Board, grieving mother and sibling

Dr Christine Newman, SickKids Palliative and Bereavement Care Service

Dr Adam Rapoport, Palliative Care Consultant, Max and Beatrice Wolfe Children's Centre

Randy Zlotnik Shaul, SickKids bioethicist


Maria: "Is it fair to ask families to participate in research?"

Zlotkin Shaul: It is "fair and reasonable to offer parents the opportunity."

Rapoport: It is "unfair not to".

Newman: Asking families "should be mandatory...I see five families here who have helped me."

Elizabeth: "To not get chance for research is taking away our choice. We don't have a lot of choices."


Maria: "What are the biggest myths surrounding research?"

Rapoport: "That there is nothing to be gained by the (palliative) individual."

Newman: "That families are too vulnerable... They are often the strongest patients."

Elizabeth: "That families have too much on their plate; let us make the decision!"


Maria: "When is the right time to speak"

Rapoport: "When we chose 3 months it was more for the REB; we want to capture info as closely as possible."

Newman: "Waiting equals protectionism, you are never over it. We want real time info. Parents can decide."

Zlotkin Shaul "Problem perhaps in that REBs not part of the wider conversation. Help educate REBs so you are on the same page; if you have better data please share with them."

Maria: "Its important to see that it's not 'them', it's all of us."


Maria: "What are the next steps?"

Elizabeth: how death effects the wider family

Newman: more work on siblings, push back during the palliative phase, include the voice of the child, starting to see inutero palliative care, look at myths to debunk, work with REBs on the time barrier to enter a study after the child's death

Rapoport: descriptive studies ok, now need more experimental designs and head to head trials otherwise we are researching hospital silos

Zlotkin Shaul: an interesting model was a summer camp with senior researchers on pregnant women who took a week to meet and brainstorm challenges with research and with REBs

Nurse comment: expand to rural areas too!

Jonathan: not being asked about Sasha's death afterward felt bizarre