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A Piece of My Mind
August 23/30, 2016

Nondisclosure

Author Affiliations
  • 1Seattle Children’s Hospital Cancer and Blood Disorders Center, Seattle, Washington
  • 2Treuman Katz Center for Pediatric Bioethics, Seattle, Washington
  • 3Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 4University of Washington School of Medicine, Seattle
JAMA. 2016;316(8):821. doi:10.1001/jama.2016.5348

Sam was 13 years old when he died of progressive cancer. On the day of his death, I was absolutely certain of one thing: we had done him wrong.

Sam was the middle of three children in a close and supportive family. They drew strength and direction from their faith and local religious community. When his cancer progressed after a last-ditch attempt at cure with a bone marrow transplant (less than a month after the transplant and a matter of weeks before his ultimate death), Sam’s parents bravely requested redirection to comfort care. They quietly went to work planning his funeral and aggressively managing his pain and other end-of-life symptoms, all the while privately grappling with their anticipatory grief.

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