David J. Bearison - Böcker

As the practice of paediatric oncology continues to advance and prognoses continue to improve, the course of treatment for children with poor prognoses becomes more biologically aggressive, more stressful, and more uncertain. Even for children who cannot be cured, new treatments have prolonged the survival of those with active disease and, consequently, medical interventions have complicated the dying process. For those who are cured, there are the lingering uncertainties of having undergone medical regimens whose adverse late effects are not yet fully understood. Consequently the field of paediatric oncology now encompasses more than strictly medical concerns. The conditions of treatment, survival, and dying have become the concerns of all health-care practitioners, including psychiatrists.This volume addresses a range of psychological issues - coping with paediatric cancer, pain and symptom management, medication compliance, sibling and family relations, care of the dying child, among others - pertaining to the practice of paediatric oncology. Each topic encompasses a substantial body of research that not only has theoretical but applied significance. Each chapter is written by a nationally recognized investigator in his or her respective area of inquiry and (1) contextually defines the research area, (2) discusses theoretical and methodological concerns of the area, (3) critically reviews and integrates research findings in the area, and (4) discusses unresolved research issues and suggests future research. The topics included are currently supported by sufficient empirical research to allow useful generalization of findings in the clinical setting.

Over 50,000 children die of medical causes each year in the U.S. and 85 percent of them do so in hospitals. While great strides have been made in palliative care, many of these children still suffer considerably in the last months of life. Studies have found that pediatricians, who often do not expect to confront death on a frequent basis, and other hospital staff typically feel inadequately trained to manage the situation and are emotionally unprepared for the death. All of the feelings associated with caring for a chronically ill child, guilt, anger, frustration, ambivalence, exhaustion, are magnified when a child's life can no longer be prolonged. When Treatment Fails will be based directly on the voices of those who care for children at the end of their lives, the doctors, nurses, social workers, pastoral counselors, and psychologists. Centered around seven cases, Bearison will elicit and record the stories of these professionals about their experiences caring for a patient. The narratives will illustrate how clinicians coming from different professional roles speak about the biological, psychological, spiritual, and social dimensions of caring for terminally ill patients. Bearison will analyze their ways of making sense and giving meaning to their difficult experiences, unearthing common and distinct themes and issues across disciplines. The book will also identify the ways their interdisciplinary teams facilitate or hinder each others work, and to what extent greater reciprocity can be achieved in providing the highest quality palliative care.