| 要約: | In pediatric hematology-oncology, technologies and medical progress generate multiple therapeutic avenues. These possibilities and the hope they raise become actors in the decision-making process. Yet, in the context of hematopoietic (bone marrow) transplants complications are numerous and death is a possibility. Based on ethnographic work conducted in a hematology-oncology unit in a pediatric hospital in Montreal, we discuss the decision-making process during poor prognoses and the challenges of moving from a curative to a palliative therapeutic trajectory as they stem from encounters with children, parents and health care providers. We question shared decision-making (patient/family/physician) and the moral role of clinicians in a context where “spontaneous deaths” rarely occur and where the option of prolonging life at all costs competes with palliative medicine.
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