CHICAGO - It's a situation too agonizing to contemplate — a child dying and in pain. Now a small but provocative study suggests that doctors may be giving fatal morphine doses to a few children dying of cancer, to end their suffering at their parents' request.

A handful of parents told researchers that they had asked doctors to hasten their children's deaths — and that doctors complied, using high doses of the powerful painkiller.

The lead author of the study and several other physicians said they doubt doctors are engaged in active mercy killing. Instead, they speculate the parents interviewed for the study mistakenly believed that doctors had followed their wishes.

A more likely scenario is that doctors increased morphine doses to ease pain, and that the children's subsequent deaths were only coincidental, said lead author Dr. Joanne Wolfe, a palliative pain specialist at Dana-Farber Cancer Institute and Children's Hospital in Boston.

The American Medical Association, American Academy of Pediatrics and most other mainstream doctor groups oppose mercy-killing but say withholding life-prolonging treatment for dying patients can be ethical....

...Dr. Walter Robinson, an ethicist and associate pediatrics professor at Vanderbilt University, said many doctors lack expertise in treating dying children's pain, and many also worry about using opiates including morphine to treat children's pain because there's an unreasonable fear of addiction.

"The lesson we should learn from the paper is the need for expert pain control. That ought to be available in every children's hospital and to every child with a life-limiting illness," Robinson said.

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