Grant Lin – Department of Neurology and Neurological Sciences, Division of Child Neurology; Stanford University School of Medicine, CA, USA Grant is a current child neurology resident and future hospice and palliative medicine fellow at Stanford University. He aims to practice as a pediatric neuropalliative physician with additional interests in the intersection of neuroprognostication and disability ethics.
Feature Articles
Mohanty, A., Large, B., Bustamante, I., Shaw, T., & Cuviello, A. (2025). Understanding of Pediatric Palliative Care Among Medical Language Interpreters. Journal of Pain & Symptom Management, 69(5), e603–e604.
Azambuja, D. B., Grekov, K., Xenakis, L., & Ullrich, C. (2025). Culture Humility: Supporting Families With Limited English Proficiency in Pediatric Palliative Care. Journal of Pain and Symptom Management, 69(5), e708–e709.
Commentary
Language concordant care is a key tenet of culturally competent and equitable care. Effective interpretation for families with limited English proficiency is paramount in conversations involving complex medical decisions and psychosocial circumstances – common occurrences in pediatric palliative care. In this month’s reference list, two conference abstracts highlight the importance of interdisciplinary collaboration with medical interpreters in pediatric palliative care.
First, Mohanty et al. conducted a survey-based assessment of Spanish medical interpreters on their clinical experiences, perceptions of end-of-life and advanced care planning conversations, and general understanding of pediatric palliative care. Most survey respondents reported feeling prepared for these conversations (88%) but lacked specific training (65%). Nearly all felt dedicated training would be helpful (94%). Their results also highlighted the importance of pre-sessions and debriefs, and two-thirds of their respondents reported emotional distress after these conversations.
Second, Azambuja et al. provide a case example demonstrating how incorporating a medical interpreter into the interdisciplinary pediatric palliative care team can enhance communication and care. Through pre-meetings and debriefs, they evaluated the appropriateness of specific palliative care language, supporting cultural humility to help establish trust. The inclusion of a dedicated interpreter also provided additional continuity of care.
Both abstracts build upon qualitative work exploring medical interpreters’ experiences in palliative care encounters. In a narrative review, Slusarz (2023) described three roles interpreters serve: (1) language conduit, (2) cultural broker, and (3) patient advocate. As a language conduit, interpreters translate medical information but can face difficulty in conveying the meaning of complex terms. For instance, Latif et al. (2023) interviewed twenty interpreters across nine languages and identified challenges such as the lack of verbatim translations for “palliative care.” As a cultural broker, interpreters provide teams with cultural context to navigate cultural differences – a role demonstrated in Azambuja et al.’s case, where the interpreter supported cultural humility. Lastly, interpreters serve as patient advocates by alerting teams and families to miscommunication and helping address families’ fears and misconceptions about palliative care.
As a child neurology resident, I have been involved in discussions surrounding diagnosis, management, and prognosis of complex medical conditions, frequently relying on the support of medical interpreters. In one case, our team felt stuck and confused when a family repeatedly declined recommendations for increasing antiseizure medications despite multiple escalations of care for breakthrough seizures. In debriefing an encounter, our interpreter suggested that our approach – presenting different medication choices with risks and benefits to allow for shared decision making and foster patient autonomy – was instead being perceived as an expectation that the medications would not work. For the family, this framing led them to try to avoid additional risk by keeping the previous medication regimen. Here, our interpreter acted as a cultural broker, helping us understand the family’s interpretation of medical uncertainty and risk.
In another case, a pre-meeting helped us identify overlapping interpretations of the words “seizure,” “spell,” and “episode,” limiting our ability to draw a clear distinction between electrographic seizures and non-epileptic events associated with a functional neurologic disorder. Together with the interpreter, we developed a strategy to adjust our word choices to minimize confusion. Here, our interpreter served as both a language conduit and patient advocate, identifying linguistic confusion and proactively suggesting strategies to improve clarity.
With a growing body of literature on medical interpreters in pediatric palliative care, several best practices have emerged. First, pre-sessions and debriefs should be conducted whenever possible1. Second, careful attention should be paid to language choice, including whether verbatim interpretations exist for terms like “palliative” or “hospice,” and avoiding metaphors or analogies3. Finally, there are opportunities for dedicated training for both interpreters and clinicians on language-concordant serious illness communication3. Ultimately, these findings underscore the importance of a genuinely interdisciplinary approach that fully integrates medical interpreters as essential members of the pediatric palliative care team.
References
- Mohanty, A., Large, B., Bustamante, I., Shaw, T., & Cuviello, A. (2025). Understanding of Pediatric Palliative Care Among Medical Language Interpreters. Journal of Pain & Symptom Management, 69(5), e603–e604.
- Azambuja, D. B., Grekov, K., Xenakis, L., & Ullrich, C. (2025). Culture Humility: Supporting Families With Limited English Proficiency in Pediatric Palliative Care. Journal of Pain and Symptom Management, 69(5), e708–e709.
- Latif Z, Makuvire T, Feder SL, et al. Experiences of Medical Interpreters During Palliative Care Encounter With Limited English Proficiency Patients: A Qualitative Study. J Palliat Med. 2023 Jun;26 (6):784-789
- Slusarz C. The roles and experiences of medical interpreters in palliative care: A narrative review. Palliat Support Care. 2023 Oct 19:1-8.
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Trends in Pediatric Palliative Care Citation List; 2025; Issue 6
Abdelmageed, S., Villalba, N., Bae, G., Mossner, J. M., Adelhoefer, S. J., Aravagiri, K., Shah, R. D., & Raskin, J. S. (2025). Neurosurgical management for chronic and end-of-life pain in children: A systematic review. Pain Practice : The Official Journal of World Institute of Pain, 25(5), e70034.
Autrey, A., Thienprayoon, R., & Jones, E. (2025). Measuring a Patient Reported Outcome: A Pediatric Palliative Care Nationwide QI Collaborative. Journal of Pain and Symptom Management, 69(5), e463–e464.
Azambuja, D. B., Grekov, K., Xenakis, L., & Ullrich, C. (2025). Culture Humility: Supporting Families With Limited English Proficiency in Pediatric Palliative Care. Journal of Pain and Symptom Management, 69(5), e708–e709.
Bakhtary, M., Sharma, P., Raspin, S., Vemuri, S., & McCarthy, M. (2025). Palliative Care for Children and Adolescents with Non-curative Brain Tumors: A Scoping Review. Journal of Palliative Medicine.
Barboza, J., Seedall, R., Hooghe, A., Kaplow, J., & Bradshaw, S. (2025). Forming our grief rhythm: The relational window of tolerance for bereaved parents. Family Process, 64(1), 1–23.
Benini, F., De Zen, L., Amarri, S., Bignamini, E., Bolognani, M., Catalano, I., Jankovic, M., Manfredini, L., Salata, M., Zanin, A., Corsello, A., Barbi, E., Marseglia, G. L., & Baraldi, E. (2025). A new palliative and pain educational model for pediatric residents. Italian Journal of Pediatrics, 51(1), 1–11.
Carroll, K., Thorvilson, M., & Collura, C. (2025). Positioning comfort measures in antenatal counselling for periviable infants. Sociology of Health & Illness, 47(2), 1–19.
Cavolo, A., Vears, D. F., Naulaers, G., de Casterlé, B. D., Gillam, L., & Gastmans, C. (2024). Doctor-Parent Disagreement for Preterm Infants Born in the Grey Zone: Do Ethical Frameworks Help? Journal of Bioethical Inquiry.
Costa, A. I. L. da, Barros, L., & Diogo, P. (2025). Emotional Labor in Pediatric Palliative Care: A Scoping Review. Nursing Reports, 15(4), 118.
Damps, M., Rybojad, B., Bartkowska-Śniatkowska, A., & Aftyka, A. (2025). Futile therapy protocols: A 3-year review of the implementation of Polish guidelines on ineffective organ function maintenance in pediatric intensive care unit—A pilot study. BMC Palliative Care, 24(1), 1–6.
DePew, R., Bonnet, K., Schlundt, D., Turnbull, J., & Propper, R. (2025). Continuation of Potentially Inappropriate Life-Sustaining Therapies: Provider Perspectives. Journal of Pain and Symptom Management.
Downing, J., Chambers, L., Daniels, A., Ling, J., Hamzah, E., Luyirika, E., Okhuysen-Cawley, R., Doherty, M., & Baker, J. N. (2025). Mapping of Children’s Palliative Care Development Globally in 2023. Children, 12(4), 440.
Downing, J., Randall, D., McNamara-Goodger, K., Ellis, P., Palat, G., Ali, Z., Hunt, J., Kiman, R., Friedel, M., & Neilson, S. (2025). Children’s palliative care and public health: Position statement. BMC Palliative Care, 24(1), 1–9.
Gouda, S., Snaman, J., & Rosenberg, A. (2025). Pediatric Palliative Care Utilization Among U.S. Children Following Out-of-hospital Cardiac Arrest. Journal of Pain and Symptom Management, 69(5), e441–e442.
Grossoehme, D. H., Friebert, S., Hendricks-Ferguson, V., Jenkins, R., Richner, G., Carst, N., Schmidt, S., Duellman, L., Schoemann, A. M., & Dias, N. (2025). Web-based psychoeducational intervention for bereaved parents. International Journal of Palliative Nursing, 31(3), 119–127.
Johnson, K., Murray, C., Patneaude, A., Major-Kincade, T., & Sartor, N. (2025). Addressing Racism in Pediatric Serious Illness: Insights for Clinical Care and Advocacy. Journal of Pain & Symptom Management, 69(5), e527–e528.
Jones, M. T., Terala, A., & Boles, J. C. (2025). “This Kind of Thing is Part of His Legacy”: Bereaved Parents’ Experiences of Participating in Interview-Based Research. Journal of Palliative Medicine.
Latremouille, G., Anderson, K., Herbst, L., Whitford, B., & Nee, K. (2025). Racial Inequalities in Pediatric Hospice Care. Journal of Pain & Symptom Management, 69(5), e663–e663.
Lee, J., Edmonson, H., Centracchio, T., & Macdonell-Yilmaz, R. (2025). Intensity of Healthcare Utilization Among Pediatric Patients Receiving Concurrent Hospice Care. Journal of Pain & Symptom Management, 69(5), e621–e622.
Macauley, R., Carter, B., & Collura, C. (2025). Who You Gonna Call? Ethical Conundrums in Pediatric End-of-Life Care. Journal of Pain & Symptom Management, 69(5), e501–e502.
Mercante, A., Nardocci, N., Fernandez-Alvarez, E., Lumsden, D. E., Hauer, J., Bernada, M., Drake, R., Kreicbergs, U., Palomo-Carrion, R., Gemma, M., Coubes, P., Fasano, A., Lin, J.-P., & Benini, F. (2025). Towards new perspectives: International consensus guidance on dystonia in pediatric palliative care. European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, 56, 24–37.
Mohanty, A., Large, B., Bustamante, I., Shaw, T., & Cuviello, A. (2025). Understanding of Pediatric Palliative Care Among Medical Language Interpreters. Journal of Pain & Symptom Management, 69(5), e603–e604.
Namisango, E., Murtagh, F. E. M., Bristowe, K., Downing, J., Powell, R. A., Atieno, M., Sandham, M., Ali, Z., Meiring, M., Mwangi-Powell, F. N., Abbas, M., Fraser, L. K., Higginson, I. J., & Harding, R. (2025). A novel child-centred core palliative care outcome measure for use in clinical practice and research: Findings from a multinational validation study. Health & Quality of Life Outcomes, 23(1), 1–16.
Nunes Maia, G., Ruschel Bandeira, D., & Centenaro Levandowski, D. (2025). Associations of Losing a Child With the Couple Relationship, Maternal Mental Health, and the Emotional Development of the Subsequent Baby. Omega: Journal of Death & Dying, 91(2), 885–903.
Peñarrubia-San-Florencio, L., Junior, C. G., Ricart, S., Vilarrubí, S. N., Ruiz-Herguido, C., Esteve, A. V., Meca-Santamaria, J., Blanco-Blanco, J., & Valls, L. L. (2025). Family perspectives and experiences on implementing telehealth in pediatric palliative care: A qualitative approach. European Journal of Pediatrics, 184(5), 1–8.
Price, J. E., Crighton, E., & Ooms, A. (2025). Teaching Sensitive Subjects Online: Lessons Learnt from the Pandemic and the Implications for Contemporary Nurse Education. Teaching & Learning in Nursing, 20(1), e54–e59.
Rana, S., DeGroote, N. P., Harris, E., Lange, A., Wasilewski-Masker, K., Klosky, J. L., Wolfe, J., Kavalieratos, D., & Brock, K. E. (n.d.). Interview Results From a Telehealth Hospice Intervention for Children and Young Adults with Cancer. Journal of Pain & Symptom Management, 343–335.
Rosa, M., Santini, A., De Tommasi, V., Agosto, C., Giacomelli, L., Papa, S., Vecchi, L., & Benini, F. (2025). The blue tick: WhatsApp as a care tool in pediatric palliative care. BMC Palliative Care, 24(1), 1–9.
Salek, M. M. D. M. P. H., Reyna, M. M. A., De Campos, D. R. M. S. N., Caneba, J. M. D., Zhou, X. M. D., García-Quintero, X. M. D. Ms., & McNeil, M. M. D. M. P. H. (2025). Co-Design & Collaboration: Global Pediatric Palliative Care Research to Address Care Inequities. Journal of Pain and Symptom Management, 69(5), e427–e428.
Sánchez, J. M. V., Sánchez, M. R., Mota Romero, E., Burgos, A. A. E., Montoya Juárez, R., Montoro, C. H., & Puente Fernández, D. (2025). Experiences of Family Caregivers of Children Aged 1-23 Months Who Have Received Pediatric Palliative Care: A Systematic Review With Qualitative Metasynthesis. J Nurs Scholarsh.
Sandler, I., Wolchik, S., Sandler, J., Tein, J.-Y., Gaffney, D., Zhang, N., & Porter, M. (2025). Feasibility, Acceptability, and Effectiveness of Adding an Evidence-Based Parent/Caregiver Program for Bereaved Families to Usual Community-Based Services. Omega: Journal of Death & Dying, 91(1), 82–100.
Scott, H. M., Gaczkowska, I., Braybrook, D., Harardottir, D., Fraser, L. K., Ellis-Smith, C., & Harding, R. (2025). Developing a Theory of Change and Implementation Plan to implement a novel child- and family-centred outcome measure in paediatric palliative care. Palliative Medicine, 2692163251331165.
Shrivastava, S. R., Bobhate, P. S., & Marar, A. M. (2025). Integrating the management of critical illness with palliative care: Public health implications. Journal of Pediatric Critical Care, 12(2), 82–85.
Tatterton, M. J., Fisher, M. J., Storton, H., McShane, Z. P., & Walker, C. (2025). “Holding Families in Uncertainty”: A Framework Analysis of the Role and Impact of Children’s Hospices in the Provision of Perinatal Palliative Care. Illness, Crisis & Loss, 33(1), 152–171.
Vivekananda, K., McDowell, C., & Knipe, K. (2025). Perinatal Bereavement Photography: A Mixed-Methods Study on Posttraumatic Growth in Parents. Illness, Crisis & Loss, 33(2), 436–453.
Waldman, E., Hemsley, J., Comac, M., & McCulloch, R. (2025). Home Based Pediatric Palliative Care in the UK: Lessons to Learn? Journal of Pain and Symptom Management, 69(5), e471.
Wang, A., Zhang, W., Li, H., Guo, Y., Yu, N. X., & Zhang, J. (2025). An 8-Week Community-Based Resilience Group Intervention for Chinese Parents Who Lost Their Only Child: A Two-Armed Pragmatic Waitlist-Control Trial. Psychological Trauma: Theory, Research, Practice & Policy, 17(1), 225–234.
Yazdani, V., Hanna, M., Yu, Q., & Mohr, G. (2025). A Case Report in Pediatric Palliative Care: Beliefs of Rebirth. Journal of Pain & Symptom Management, 69(5), e741–e742.