The Children's Ombudsman states that in the context of palliative care for children, as a
special group that needs to be protected, the issue of convenience and accessibility of given services
is a pressing one. Thus, when a child is seriously ill, every member of the family is affected.
Therefore, it is important that in addition to the qualitative care provided to the child, the necessary
assistance to be also provided to the family, as the closest and most trusted circle of the child.
The study found that in the Republic of Moldova pediatric palliative care practically does
not exist, except in a specialized section at the Oncology Institute. Beds are also provided in the
clinical protocol for the palliation of children with cancer, but there is no normative provision and
possibility for palliative care for children with non-oncological conditions. Children in serious
conditions, who need palliative care are hospitalized in pediatric hospitals with a general profile, in
the intensive care unit or chronic diseases, for long periods, according to vital needs, being
connected to life support devices. However, so far, no mechanism for calculating and financing
these cases has been developed, the NHIC refusing to pay them. Thus, hospitals are required to
cover these huge expenses from their own funds, which affects the access and quality of medical
services needed by other children admitted to these institutions, including access to intensive care
equipment that is blocked for months and even years by children in irreversible states. There are not
enough specialized human resources in the country in this field.
In concluding the above, the Children's Ombudsman considers that the central public
authorities have not made sufficient efforts to develop the palliative care service for children, which
is why it cannot reach international quality standards in the field of child protection.
Another aspect of the child's right to health, examined by the People's Advocate for
Children's Rights during the reporting period, was the provision of medical care to children
without parental consent or in the case of the parent's refusal to medical care, an issue addressed
by the authorities and individuals in several addresses to the Children's Ombudsman. The parent's
refusal to medical care is currently one of the most difficult dilemmas of medical ethics and
jurisprudence. Thus, although at present Law no. 338 of December 15, 1994 on children's rights to
Art. 4, para. (4) provides that if "the parents refuse medical care for the sick child, it is granted
against their will, at the decision of the board of doctors, taken in the presence of the power
representative155”, the problem at the practical level is not solved.
155
http://www.legis.md/cautare/getResults?doc_id=94939&lang=ro
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