By Marie-Alem OUKACI

The International Convention on the Rights of the Child of 1989 introduced, within the national jurisdiction of the signatory States, the notion of the “best interest” of the child. This presupposes that during each decision making process, the foremost focus is on the well-being of the child.
A parent’s serious illness can be considered as a real incident in the child’s life. It is the source of upheavals, which are mental, emotional and material in nature. The evolution of family configurations (single parent and/or stepfamilies) and the fact that women have their first child progressively later in life reinforce these repercussions. These two associated phenomena constitute a crucial issue for the child, whose said “best interest” becomes a major preoccupation for professionals in the areas of Childhood and Health.

Such is the example of Freddy, 12 years old, having come from the Ivory Coast to live in France with his mother Mrs. B., who is suffering with cancer. His parents are divorced. His family remained in Africa.
Having been urgently hospitalized, Freddy’s mother had verbalized, some days before her death, her last wishes in regards to her son: she wanted him to finish his school year in France and to remain to live at a friend’s home.
The patient had decided to not inform the child’s school of her illness and prognostic. When the child arrived at the clinical service for the first time, he was accompanied by his aunt who had urgently come in from the Ivory Coast. What did the child know of the situation? Very little. Does he know that his mother is sick? Yes. Does he know that it is serious? No. That it is the end? He hasn’t a clue…

Mrs. B. dies three days after her son’s visit.
Freddy has now become a minor foreigner isolated on French territory.
The justice system is now faced with the will of a deceased mother and to the rights of a father, who recognized the child and who lives in Africa.

Until where must we/should we go to respect the choice of the patient?
Until what point should the child be informed? At which moment? By whom?
Such questions call upon the responsibility of all of the actors of the institution and of the home.

The last report of the End of Life National Observatory (18/03/2013) indicated that more than 60% of the French population dies at the hospital, while 80% of the population wishes to end their life in their homes.
The place of the child in the process of care of a parent becomes a key issue for the hospital institution. One must especially rethink the restriction of visitation rights, which are generally applied to minors of less than 15 years of age, but the regulations and the reasons differ among hospitals.
The issue at stake is to conjugate the rights of the child and the rights of the ill parent. The said rights are part of the sociocultural realities which are specific to each of territory.     

In addition, questioning the child’s best interest supposes that we know the child. This consideration calls for a close collaboration between the health facility which cares for the sick parent, and the child’s housing facility: the nursery, the school… It is for these different actors to consider coordinated care for the child as soon as the diagnostic is announced, in order to favor the psycho-affective development of the child and to lessen the risk of pathological grievance.

The rights of the child constitute a major challenge in our society, which is increasingly turned towards technical performances. What is at stake is to adapt the existing actions, while also demonstrating creativity by developing tools for children, for the parents and for concerned professionals.

Marie-Alem OUKACI

The International Convention on the Rights of the Child of 1989 introduced, within the national jurisdiction of the signatory States, the notion of the “best interest” of the child. This presupposes that during each decision making process, the foremost focus is on the well-being of the child.
A parent’s serious illness can be considered as a real incident in the child’s life. It is the source of upheavals, which are mental, emotional and material in nature. The evolution of family configurations (single parent and/or stepfamilies) and the fact that women have their first child progressively later in life reinforce these repercussions. These two associated phenomena constitute a crucial issue for the child, whose said “best interest” becomes a major preoccupation for professionals in the areas of Childhood and Health.

Such is the example of Freddy, 12 years old, having come from the Ivory Coast to live in France with his mother Mrs. B., who is suffering with cancer. His parents are divorced. His family remained in Africa.
Having been urgently hospitalized, Freddy’s mother had verbalized, some days before her death, her last wishes in regards to her son: she wanted him to finish his school year in France and to remain to live at a friend’s home.
The patient had decided to not inform the child’s school of her illness and prognostic. When the child arrived at the clinical service for the first time, he was accompanied by his aunt who had urgently come in from the Ivory Coast. What did the child know of the situation? Very little. Does he know that his mother is sick? Yes. Does he know that it is serious? No. That it is the end? He hasn’t a clue…

Mrs. B. dies three days after her son’s visit.
Freddy has now become a minor foreigner isolated on French territory.
The justice system is now faced with the will of a deceased mother and to the rights of a father, who recognized the child and who lives in Africa.

Until where must we/should we go to respect the choice of the patient?
Until what point should the child be informed? At which moment? By whom?
Such questions call upon the responsibility of all of the actors of the institution and of the home.

The last report of the End of Life National Observatory (18/03/2013) indicated that more than 60% of the French population dies at the hospital, while 80% of the population wishes to end their life in their homes.
The place of the child in the process of care of a parent becomes a key issue for the hospital institution. One must especially rethink the restriction of visitation rights, which are generally applied to minors of less than 15 years of age, but the regulations and the reasons differ among hospitals.
The issue at stake is to conjugate the rights of the child and the rights of the ill parent. The said rights are part of the sociocultural realities which are specific to each of territory.     

In addition, questioning the child’s best interest supposes that we know the child. This consideration calls for a close collaboration between the health facility which cares for the sick parent, and the child’s housing facility: the nursery, the school… It is for these different actors to consider coordinated care for the child as soon as the diagnostic is announced, in order to favor the psycho-affective development of the child and to lessen the risk of pathological grievance.

The rights of the child constitute a major challenge in our society, which is increasingly turned towards technical performances. What is at stake is to adapt the existing actions, while also demonstrating creativity by developing tools for children, for the parents and for concerned professionals.

Marie-Alem OUKACI

The International Convention on the Rights of the Child of 1989 introduced, within the national jurisdiction of the signatory States, the notion of the “best interest” of the child. This presupposes that during each decision making process, the foremost focus is on the well-being of the child.
A parent’s serious illness can be considered as a real incident in the child’s life. It is the source of upheavals, which are mental, emotional and material in nature. The evolution of family configurations (single parent and/or stepfamilies) and the fact that women have their first child progressively later in life reinforce these repercussions. These two associated phenomena constitute a crucial issue for the child, whose said “best interest” becomes a major preoccupation for professionals in the areas of Childhood and Health.

Such is the example of Freddy, 12 years old, having come from the Ivory Coast to live in France with his mother Mrs. B., who is suffering with cancer. His parents are divorced. His family remained in Africa.
Having been urgently hospitalized, Freddy’s mother had verbalized, some days before her death, her last wishes in regards to her son: she wanted him to finish his school year in France and to remain to live at a friend’s home.
The patient had decided to not inform the child’s school of her illness and prognostic. When the child arrived at the clinical service for the first time, he was accompanied by his aunt who had urgently come in from the Ivory Coast. What did the child know of the situation? Very little. Does he know that his mother is sick? Yes. Does he know that it is serious? No. That it is the end? He hasn’t a clue…

Mrs. B. dies three days after her son’s visit.
Freddy has now become a minor foreigner isolated on French territory.
The justice system is now faced with the will of a deceased mother and to the rights of a father, who recognized the child and who lives in Africa.

Until where must we/should we go to respect the choice of the patient?
Until what point should the child be informed? At which moment? By whom?
Such questions call upon the responsibility of all of the actors of the institution and of the home.

The last report of the End of Life National Observatory (18/03/2013) indicated that more than 60% of the French population dies at the hospital, while 80% of the population wishes to end their life in their homes.
The place of the child in the process of care of a parent becomes a key issue for the hospital institution. One must especially rethink the restriction of visitation rights, which are generally applied to minors of less than 15 years of age, but the regulations and the reasons differ among hospitals.
The issue at stake is to conjugate the rights of the child and the rights of the ill parent. The said rights are part of the sociocultural realities which are specific to each of territory.     

In addition, questioning the child’s best interest supposes that we know the child. This consideration calls for a close collaboration between the health facility which cares for the sick parent, and the child’s housing facility: the nursery, the school… It is for these different actors to consider coordinated care for the child as soon as the diagnostic is announced, in order to favor the psycho-affective development of the child and to lessen the risk of pathological grievance.

The rights of the child constitute a major challenge in our society, which is increasingly turned towards technical performances. What is at stake is to adapt the existing actions, while also demonstrating creativity by developing tools for children, for the parents and for concerned professionals.

Marie-Alem OUKACI