Pediatric Palliative Care  Services

Mission Statement:

     The University of Virginia Children's Hospital strives to provide seamless health care, education and support to children and their families.  Using the recommendations outlined in a statement published by the American Academy of Pediatrics in August 2000*, the Pediatric Palliative Care Service provides a model of integrated, multidisciplinary care for children with life-limiting conditions.  Our mission is fourfold:

  • to provide exemplary care for pediatric patients and their families facing life-limiting conditions that is multidisciplinary and comprehensive, compassionate and respectful, current and unique,
  • to advocate for patient- and family-centered goals at multiple levels institutionally, locally and nationally,
  • to teach pediatric palliative care principles and practices through all levels of medical, nursing, chaplaincy, therapy and other health-related disciplines that participate in the care of children,
  • to research and explore the best practices, educational tools and policy initiatives that impact the rapidly growing field of pediatric palliative care and contribute to the scholarship that supports these efforts.

Background:

     While infant and child mortality in the United States has declined over generations, the death of a child is still a reality for many families.  Vital statistics from 2002 demonstrate nearly 58,000 children between 0 and 19 years of age died that year, with a little over half of them being infants**.  Causes of pediatric mortality are varied and include congenital disorders, inherited conditions, acquired diseases and trauma.  When a disease or condition is discovered in a child child that predicts he or she will not survive to adulthood, that child and family have the opportunity to  benefit from palliative care.  Pediatric patients at the UVA Children's Hospital with a life-limiting condition and their families benefit from an integrated model of health care, research and education, and multidisciplinary support that balances goals of cure, disease control, life-prolongation and palliative care.

     Palliative care provides pain and symptom management and emotional, psychological and spiritual support to enhance the patient's qualify of life***.  It is an integrated and proactive discipline that designs and implements therapeutic plans to provide maximum comfort and function for the child and family as a unit****.  In any encounter of health care delivery that is compassionate, the goals of palliative are are present; these palliative care goals and plans of care work in concert with ongoing curative treatment and efforts.  At a time when curative and treatment efforts may be declined as too burdensome for their anticipated benefit, the palliative care goals remain, and those treatment plans actively and collaboratively proceed.  Palliative care neither prolongs nor hastens death but regards it as a normal process.  It embodies a philosophy that seeks to enhance life no matter its expected duration.

*American Academy of Pediatrics, Committee on Bioethics and Committee on Hospital Care.  Palliative Care for Children.  Pediatrics 2000; 106:351-7.

**National Vital Satistics Report.  September, 2004.

***Davies B, Steele R.  Challenges in Identifying Children for Palliative Care.  Journal of Palliative Care, 1996; 12:5-8.

****Post LF, Duber NN.  Palliative Care: a Bioethical Definition, Principles, and Clinical Guidelines.  Bioethics Forum, 1997; 13:17-24.