Health emigration: a challenge in paediatric oncology.

For the past 10 years European states have experienced an increasing flow of emigrating families from developing countries seeking better medical care for their sick children. For Italian paediatricians this has become a new challenge, considering the cultural differences in customs regarding the illness. The onset of a life-threatening disease has a strong impact on the family.

Young siblings of children with cancer deserve care and a personalized approach.

The youngest siblings may be both emotionally vulnerable and often neglected members of the family of a childhood cancer patient. The prompt identification of signs of distress in these subjects allows trained caregivers to intervene with personalized, age-appropriate, attention, and care. A narrative approach, based on personalized listening, writings, and spontaneous drawings, can provide the means to elicit markers of psychological maladjustment in even the youngest of siblings.

Randomization, informed consent and physicians' communication skills in pediatric oncology: a delicate balance.

Parents asked to consent to a child's randomization in a pediatric cancer clinical trial are often unprepared to grasp the implications of this scientifically crucial but seemingly unfair process. Physicians must adopt specific communication skills to engage families in open dialogue from the outset in order to elicit truly shared informed consent. Starting from the case of a family with an only child affected by disseminated neuroblastoma, we wish to comment on the problems surfacing in the informed consent process for treatment and research in pediatric oncology that implicate an understanding of bioethical issues and psychological principles.

From informed consent to shared consent: a developing process in paediatric oncology.

Little research has been done on consent in clinical management of cancer in children. Many parents think that the informed-consent process is helpful but often confusing; discussions regularly prove more helpful. It can be difficult for parents to understand the notion of randomisation, not to mention the request for consent to this procedure.