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Grief occurs when one is deprived from something valuable, people deal
with this emotion according to Kübler-Ross (1969),
in the 5 stages of Grief cycle. Its helps explain the
experience loved ones and the patients themselves have from dying of a terminal
illness. It is once thought that the stages had to be engaged in order however;
more recent research by Baxter & Diehl (1998) found that a person in grief would
experience each stage in a different order than another. One stage of grief is
denial. The child with terminal cancer in this case could refuse to believe
that the information given about their illness is true, or a loved one refusing
to believe that the child has died. This is the point paramedics would come in
contact with the stages of grief most. It is also significant to understand
that this denial stage is a defense mechanism and is natural. Anger is the next
stage of grief. In children this will depend on their age and development, children
under the age of 9 do not understand the conclusiveness of death. (Marie Curie, 2014)
When a paramedic comes into contact with a loved one that is in the anger stage
of grief it is necessary to use good communication methods to calm the patient
but be aware of the danger that could come from the anger. Bargaining conventionally
is the stage of grief when the affected will try and reason with their
‘god’.  However, this does depend on the
person and what they believe in, they could be bargaining with anything or
anyone at this desperate time. Depression is the next stage of grief, the child
or loved one may portray extreme sadness, a feeling of uncertainty or fear.
Lastly the patient or close family member will accept what is happening. The
patient may accept they have the illness or the loved one accept that the
patient has died. The
5 stages of grief are necessary, it helps patients and their families move from
intense sadness, isolation, loneliness and finally connection to reality.

Paramedics sadly are not overly prepared to deal with palliative care or
grief, as the Health and Care Professions Council Standards of Proficiency
(2007) is mostly centered on management of acute medical emergencies and not specifically
palliative care.  Nevertheless, it does
say that a paramedic does have to deal with psychological
and social factors that influence an individual in health and illness, whether
it is the family surrounding that individual or the patient themselves. Paramedics
are not yet trained to be suited to the role of palliative care for adults or
children and further specialised training is needed. (Kirk, 2019)

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Politics in
peadiactric terminal cancer has always been an important topic of modern news. A
petition originating from MadeforMums (2017) evidences this fact, its headline; ‘Children’s cancer petition calls
on Department of Health to do more.’ Another prevalent headline from The
Guardian (2017) states; ‘Brexit and the treatment of children with cancer.’
This article argues that Brexit will harm the chance of children having the
best quality of drug treatment because EU clinical trial regulations will ruin
the opportunity for clinical trials to run in the UK and Europe simultaneously.
Leading to the possible missed opportunity of a health-enhancing drug to be
found in childhood terminal cancer cases. Politics in paediactric terminal
cancer can only be positive, as it will keep awareness of the illness in
society. (National Health Service, 2017) (Lord B et al,
2012) The role of healthcare on the society is changing all the time. It adapts
between times, cultures, religions, individuals and social societies. (Browne,
2008) Times have changed, especially for childhood terminal cancer, with new
medical research providing alternative treatments enhancing life. A study on
children with cancer in 29 separate African countries, found that care was
significantly poorer than that in European countries. They stated ‘capabilities for care of children with cancer varied
widely.’ Social construction wise, the African population has a decreased
confidence in childhood cancer survival compared to the
UK but is taking actions to change this however, depending what religion,
culture or tribe also alters whether the families will seek help for their
children. (Stefan, 2015) In the Stefan (2015) study, questionnaires
were used; the use of questionnaires can cause low validity on a study due to
respondent dishonesty and a lack of conscious responses. However, this study
does provide an insight into the differences of social construction.

 

A publication stated ‘100000 children
die from cancer before the age of 15 years, more than 90% of them in resource-limited
countries.’ As for this fact they presented a catalogue of proposals including reforms,
which can make healthcare affordable for all. These were; sustainable funding,
more research networks, better clinical research and clinical trial innovation.
Policies however are not a quick solution if there is a lack of money. Without
the funding it would be hard to initiate the proposals. (Sullivan et al, 2013)
Like policies in the UK, it is possible for paramedics to fill in for the lack
of other medical professional roles. Making services cheaper, quicker and
minimising hospital admissions. In these cases community paramedics would be
based in GP surgeries, critical care paramedics based in hospital intensive
care facilities, treat and refer paramedics in minor injury units and finally Accident
and Emergency (A) paramedics in A. (Ball, 2005)

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