Neither the "devil's lettuce" nor a "miracle cure": The use of medical cannabis in the care of children and youth infographic

Text Version

NEITHER THE "DEVIL'S LETTUCE" NOR A "MIRACLE CURE": THE USE OF MEDICAL CANNABIS IN THE CARE OF CHILDREN AND YOUTH

In June 2021, stakeholders from North and South America, Europe, and Australia explored key ethical issues shaping the landscape of medical cannabis for children and youth, as well as their implications for research and policy in two consecutive workshops.

Stakeholders and Key Topics

Public: N>80 parents, caregivers, clinicians, and researchers.

Experts: N=30 ethicists, clinicians, researchers, policy makers, patient and industry representatives.

Each session was recorded, transcribed and analyzed. There were three key topic areas for each discussion:

  1. The scientific and regulatory landscape for medical cannabis

  2. Surrogate decision making and assent

  3. Social and political culture of cannabis

Recommendations

Research

  1. Discovery science and the reach of translational results.

    There is a need for rigorous data in a range of pediatric conditions, improved communications, and educational resources.

  2. History and plant physiology of cannabis

    Innovative study deigns must not be blind to history or ignore traditional knowledges about cannabis.

  3. Reformed and harmonized research regulations and policies

    Objective definitions of effectiveness, efficacy and safety, person-centered and harmonized guidance for cannabis research should be considerations for policy-makers and ethics oversight bodies.

Clinical Practice

  1. Harm reduction

    Adoption of trust, transparency, and truthfulness into clinical encounters will decrease stigma, address health inequalities, and facilitate informed choice.

  2. Clinician hesitancy

    Clinicians can recognize how personal and societal beliefs influence interpretation of data and interactions by incorporating the principles of epistemic humility and justice.

  3. Reliable and accessible informational resources

    Centralized, authoritative resources on risks and benefits, dosing and administration, and product source will promote informed choice, maximize possible benefits and minimize potential harms for patients.

  4. Self-determination

    Use of trauma-informed practices, strength-based, collaborative care, compassion, and allyship can help re-focus clinical encounters with children.

Research and Clinical Ethics

  1. Diverse perspectives of health equity

    Stakeholders can build roads to improved health equity for historically marginalized populations by embracing strength-based approaches to diverse views and different knowledges.

  2. Relationships with industry

    Attention must be paid to standards for industry funding and collaboration for research, including product standardization and communication of research results.

For more information, visit www.medcannkids.ca

Produced by Sophia Mbabaali in March 2022.

C4T is an academic partnership. Funding details and COI are available on our website.

This work has been supported by the Canadian Institutes of Health Research and the Canadian Cancer Society (Grant No. 707031).

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Clinician Views on and Ethics Priorities for Authorizing Medical Cannabis

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Medical Cannabis in Pediatric Oncology: A Survey of Patients and Caregivers