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MBBS (Guy’s, KCL 1986), MSc (Pharmacology, Toronto 1993), MSt (Ethics and Theology, Oxford, 2012), MD (Pharmacology, Inst Cancer Res 1996), FRCPE (Paeds, 1990), FRCPCH (2000), Dip Pall Med (Cardiff 1998), PGCert Prof Clin Ed (Bangor, 2011), FHEA (2009)


Richard Hain is a Consultant and Clinical Lead in Paediatric Palliative Medicine in Wales. His clinical post is based at the Children’s Hospital in Cardiff and he provides an all Wales specialist service via a managed clinical network, alongside consultant colleagues Dr Meg Baba, Dr Jo Griffiths and Dr Jennifer Evans. He also provides a secondary service for patients in Cardiff and the Vale University Health Board. His work includes seeing patients at Tŷ Hafan Children’s Hospice. The Managed Clinical Network comprises local paediatricians in each of the health boards across Wales.

Dr Hain’s academic background is varied and includes postgraduate degrees in pharmacology, professional education and ethics and theology. He has co-authored over fifty research and review articles, four books on children’s palliative medicine and a large number of book chapters. His primary research interest is in the principles and practice of paediatric palliative medicine, and he is increasingly focusing on clinical ethics in children at the end of life. He is honorary Professor in the College of Human and Health Sciences at Swansea University .

Professor Hain is Chair of the Cardiff and Vale University Health Board Independent Patient Funding Review Panel.


Registered with GMC July 1987
Clinical training (Leeds, Hammersmith, Guy’s, Toronto, South-West Deanery, Ottawa, Wales Deanery)
Postgraduate qualifications in pharmacology, palliative medicine and education
Clinical specialist certification (1999) in paediatrics, paediatric oncology and adult palliative medicine
Senior Lecturer, Cardiff University 2000 – 2012
Consultant and Clinical Lead, Cardiff and Vale UHB, 2012 – present


Professor Hain has published work in four areas:

• Ethics around the end of life
• Epidemiology and service development in paediatric palliative care
• Opioid pharmacology and symptom control therapeutics
• Paediatric oncology and haematology


Achieving Consensus. Mike Linney, Richard Hain, Dominic Wilkinson, Peter-Marc Fortune, Sarah Barclay, Vic Larcher, Jacqueline Fitzgerald and Emily Arkell . Archives Disease in Childhood 2019 (in press)

Hospices and palliative care for children: converging stories Richard Hain. British Medical Bulletin 2019 (in press)

Voices of moral authority: parents, doctors and what will actually help. Hain RDW. (2018). Journal of Medical Ethics.44(7).

Core Ethics for Health Professionals: Principles, Issues and Compliance. Hain RDW. (2018). The New Bioethics.24(2):193-5.

Ethics in Paediatric Palliative Care Hain, R. D. W. in Oxford Textbook of Palliative Medicine (2nd ed), Dr Nathan Cherny ed. Oxford University Press (in press)

Medical Curriculum in Transition: Audit and Student Perspective of Undergraduate Teaching of Ethics and Professionalism.. Saad, T. C., Riley, S., & Hain, R. (2017). Journal of Medical Ethics. doi: 10.1136/medethics-2016-103488

Foundations of practical ethics. Hain R, Saad T. Medicine. (2016);44(10):578-82.

Consent. Hain R. Medicine. (2016);44(1-):593-5.

Ethics in Paediatric Palliative Care Hain, R. D. W. in Oxford Textbook of Palliative Medicine, Dr Nathan Cherny, Prof Marie Fallon, Prof Stein Kassa, Dr Russell Portenoy, and Prof David C. Currow eds. Oxford University Press 2015 (ISBN-13: 9780199656097)

Teddy Houlston’s short life tells us so much about what it is to be human. Richard Hain. Observer 26 April 2015

Euthanasia: 10 myths. Hain RD. Arch Dis Child 2014;99:9 798-799 Published Online First: 12 July 2014

Spirituality among paediatric palliative care staff: A Survey. Brown K, Williams T, Lapwood S, Hain R. RELAY (Together for short lives) 2013(1):10-14

Intensive care: because you’re worth it Hain, RDW. Thinking Faith (online journal of British Jesuits) December 2012

Mere Practicality: Singer on infanticide. Hain, RDW. Paper presented at the Kirby Laing Institute for Christian Ethics, October 2012

Is it really ‘Choosing to Die’ ? Hain R. Triple Helix 2011(Winter):10-11

Withholding intensive care in the child who will inevitably die. Primum non nocere – Primum adiuvare! Khalil,D, Fardy,CH, Hain,RDW. The Welsh Paediatric Journal, 2007, 27: 13-18.

Ethical dimensions of palliative chemotherapy, RDW Hain, K Maisey, R Cox, T Kus, M Devins, RE Davies, Archives of Disease in Childhood 2004, 89 (Suppl 1): A35. (oral presentation)

Euthanasia: an evidence based approach RDW Hain. Appraisal Journal of Practical Philosophy 2001; 3(3): 106-109

Doctors’ autonomy (as D Orchard). British Medical Journal 1998; 317:1730-1731

Paediatric palliative care: epidemiology and service development

Emergency care planning: are we discussing it, are we recording and, and are we acting on it ? An audit of ECP implementation in children with life-limiting conditions. Artis, G., Cunningham, C., Halpin-Evans, R., Hain, RDW. Archives of Disease in Childhood 2016; 101(S1) : A1-A374)

Patterns of child death in England and Wales. Sidebotham P, Fraser J, Fleming P, Ward-Platt M, Hain R. The Lancet. 2014;384(9946):904-14.

Paediatric palliative care: development and pilot study of a ‘Directory’ of life-limiting conditions. Hain R, Devins M, Hastings R, Noyes J. BMC Palliat Care. 2013;12(1):43.

The Paediatric Palliative Screening Scale: Further validity testing. Bergstraesser E, Paul M, Rufibach K, Hain RD, Held L. Palliative medicine. 2013;28(6):530-3.

Planning ahead with children with life-limiting conditions and their families: development, implementation and evaluation of ‘My Choices’. Noyes J, Hastings RP, Lewis M, et al. BMC Palliat Care 2013;12:5 doi: 1472-684X-12-5

The development of an instrument that can identify children with palliative care needs; the paediatric palliative screening scale (PaPaS Scale): a qualitative study approach. Bergstraesser E, Hain RD, Pereira JL. BMC Palliat Care. 2013;12(20)

Rising national prevalence of life-limiting conditions in children in England. Fraser LK, Miller M, Hain R, et al. Pediatrics 2012;129(4):e923-9

Pediatric palliative care provision around the world: a systematic review. Knapp C, Woodworth L, Wright M, et al. Pediatr Blood Cancer 2011;57(3):361-8 (IF 2.2).

Disease trajectories and ACT/RCPCH categories in paediatric palliative care. Wood F, Simpson S, Barnes E, Hain R. Palliat Med. 2010;24(8):11 IF=2

Place and provision of palliative care for children with progressive cancer: a PONF/UKCCSG study. Vickers, J., Thompson, A., Collins, GS., Childs, M., Hain, RDW J Clin Oncol 2007;25(28):4472-6. IF=17

Palliative care in children in Wales: a study of provision and need. RDW Hain. Palliative Medicine 2005, 19: 137-142. IF=2

Colleagues’ Perception of a Hospital Palliative medicine Service RDW Hain, S Mirando. Palliative medicine Today 2001; 10(1):12-14.

Paediatric palliative care: symptom control and opioid pharmacology

‘Total Pain’ in Children with Severe Neurological Impairment
Timothy A Warlow , Richard DW Hain (2018). " Children (Basel) 5(1).

Siblings of children with life-limiting conditions : psychological adjustment and sibling relationships. Fullerton JM, Totsika V, Hain R, Hastings RP. Child: care, health and development. 2016 Nov 1. PubMed PMID: 27804151

Measuring the Pain of Mucositis using Oucher and DEGR Richard Hain, Meriel Jenney, Ben Carter and Ruth Davies. J Palliat Care Med 2015: 5:222. doi: 10.4172/2165-7386.1000222

Guideline for the Prevention of Acute Nausea and Vomiting Due to Antineoplastic Medication in Pediatric Cancer Patients. Dupuis LL, Boodhan S, Holdsworth M, et al. Pediatr Blood Cancer 2013 doi: 10.1002/pbc.24508

Challenging symptoms in children with rare life-limiting conditions: findings from a prospective diary and interview study with families. Malcolm C, Hain R, Gibson F, Adams S, Anderson G, Forbat L. Acta Paediatr 2012;101(9):985-92 (IF 2.1)

Challenging symptom profiles of life-limiting conditions in children: a survey of care professionals and families Malcolm, C., Hain RDW, Forbat, E Palliat Med. 2011 Jun;25(4):357-64. IF=2

Guideline for the Classification of the Acute Emetogenic Potential of Antineoplastic Medication in Pediatric Cancer Patients. Dupuis LL., Dan L., Boodhan S., Sung, L., Portwine, C., Hain, RDW, McCarthy, P., Holdsworth. M. Pediatr Blood Cancer 2011;57:191–198 IF=2.2

Pharmacokinetic and pharmacodynamic study of morphine and morphine 6-glucuronide after oral and intravenous administration of morphine in children with cancer. Mashayekhi SO, Ghandforoush-Sattari M, Routledge PA, Hain RD. Biopharm Drug Dispos. 2009 Mar 3. IF=1

Rapid and sensitive quantitation of morphine using HPLC with electrochemical detection. Mashayekhi SO, Ghandforoush-Sattari M, Hain RD. J Clin Pharm Ther. 2008 Aug;33(4):419-27. IF=1.8

Opioid use in palliative care of children and young people with cancer. Hewitt, M., Goldman, A., Collins, G., Childs, M., Hain, RDW. Journal of Pediatrics, 2008, 152: 39-44. IF=4.1

Morphine in cancer: impact of age, chemotherapy and other factors on plasma protein binding Mashayekhi, SO, Hain, RDW., Buss, D., and Routledge, PA. Journal of Palliative Care Pharmacotherapy 2007 21(4):5-12. IF=1.4

Morphine-6-glucuronide assay using a competitive ELISA assay Mashayekhi, SO, Ghandforoush-sattari, MR, Hain, RDW, Nixon, LS, Routledge, PA Pharmaceutical Sciences 2007 Spring:51-60

Palliative care of a paediatric patient with relapsed neuroblastoma. Hildebrandt T, Venables J, Hain R. European Journal of Palliative Care 2006, 13: 101-2.

Symptoms in children/young people with progressive malignant disease: United Kingdom Children’s Cancer Study Group/Paediatric Oncology Nurses Forum survey. Goldman A, Hewitt M, Collins GS, Childs M, Hain R. Pediatrics 2006;117(6):e1179-86. IF=4.7

Prophylaxis of acute chemotherapy-induced nausea and vomiting in children with cancer: What is the evidence? Antonarakis ES, Evans JL, Heard GF, Noonan LM, Pizer BL, Hain RDW. Pediatric Blood & Cancer 2004, 43 (6): 651-658. IF= 2.2

Invasive procedures carried out in conscious children: contrast between North American and European paediatric oncology centres RDW Hain, C Campbell. Archives of Disease in Childhood 2001; 85:12-15.

Morphine and morphine-6-glucuronide in the plasma and cerebrospinal fluid of children Hain, R.D.W., Hardcastle, A., Pinkerton, C.R. and Aherne, G.W. Br J Clin Pharmacol, 1999 48, 37-42.

Hydromorphone and metabolite pharmacokinetics in children. N Babul, AC Darker, RDW Hain. Journal of Pain and Symptom Management 1995; 5:335-337

Respiratory symptoms in children dying from malignant disease RDW Hain, N Patel, S Crabtree, CR Pinkerton. Palliative Medicine 1995; 9:203-208

Morphine metabolism in children. IA Choonara, P McKay, RDW Hain, A Rane. British Journal of Clinical Pharmacology 1989;28(5):599-604.

Paediatric oncology and haematology

Sequential acquisition of fusion genes and genome-wide copy number alterations in acute lymphoblastic leukaemia. Bateman, CM., Colman, SM., Chaplin, T., Bryan D. Young, Eden, TO., Bhakta, M., Gratias, EJ., van Wering, ER., Cazzaniga, G., Harrison, CJ., Hain, RDW., Ancliff, P., Ford, AM., Kearney, L. and Greaves, M. Blood. 2010 Apr 29;115(17):3553-8. IF=11

Complex chromosomal abnormalities in utero, five years before leukaemia, ZJ Broadfield, RDW Hain, CJ Harrison, GR Jalali, M McKinley, K Michalova, HM Robinson, Z Zemanova, M Martineau, British Journal of Haematology 2004, 126. 307-312. IF=4.6

Acute tumour lysis syndrome with no evidence of tumour load RDW Hain, E Harvey, A Poon, S Weitzman. Pediatric Nephrology 1994; 8(5):537-539

Polymerase chain reaction and direct nucleotide sequencing in the diagnosis of haemoglobin FM-Fort Ripley. RDW Hain, D Chitayat, E Cooper, E Bandler, D Chui, M Freedman. Human Mutation 1994; 3:239-242

Acute tumour lysis syndrome complicating treatment of stage IVS neuroblastoma. RDW Hain, L Rayner, S Weitzman, A Lorenzana. Medical and Pediatric Oncology 1994; 23:136-139

A second observation of the fetal methemoglobin variant Hb FM-Fort Ripley. TP Molchanova, JB Wilson, L-H Gu, RDW Hain, LS Chang, THJ Huisman. Hemoglobin 1992; 16(5):389-398

Myelodysplasia as the initial presentation of Fanconi’s anaemia in a phenotypically normal child. MF McMullin, P Mahendra, RDW Hain, AJ Barrett. Clinical and Laboratory Haematology 1991;13(4):387-389.


Paediatric palliative medicine in the UK: past, present, future. Hain R, Heckford E, McCulloch R. Arch Dis Child 2012;97(4):381-4

Children: Different but the same species Hain, R.D.W and Ballantine, N. European Journal of Palliative Care 2011 18(6) 288

Paediatric palliative care: not so different from adult palliative care? Mellor C, Hain R. Br J Hosp Med (Lond) 2010. Jan;71(1):36-9.

Predicting death in children, Brook, L.A. and Hain, R.D. Arch Dis Child 2008 93:1067-1070.

Progress in palliative care for children in the UK, RDW Hain & A Wallace, Paediatrics and Child Health 2008, 18 (3): 141-146.

Strong opioids in paediatric palliative medicine, RDW Hain, A. Miser, M Devins and WHB Wallace, Pediatric Drugs 2005 7(1): 1-9

Nausea and vomiting associated with cancer chemotherapy in children: drug management in theory and in practice, ES Antonarakis & RDW Hain, Archives of Disease in Childhood 2004, 89(9), 877-880.

Pharmacological management of paediatric procedure related cancer pain, RDW Hain & C Liossi, Welsh Paediatric Journal 2004, 20, 46-55.

Paediatric palliative medicine: a unique challenge Hain RDW. Pediatric Rehabilitation. 2004 7 (2): 79-84.

Terminal care in paediatrics: where we are now? Hutchinson, F., King, N. and RDW Hain Postgraduate Medical Journal 2003, 79: 566-568.

Training in paediatric palliative medicine. RDW Hain , A. Goldman . Palliative Medicine 2003;17(3):229-31.

Palliative medicine in children: moving forward Watterston, G. and RDW Hain Current Paediatrics 2003: 13(3);221-25.

Finding information about your drugs. Hain, T.C.A. and RDW Hain I-Can 1:18-19 (2002)

Opioids in children: perhaps less is more RDW Hain. Welsh Paediatric Journal 2002; 16:70-73

Paediatric palliative medicine – the view from a bridge RDW Hain. European Journal of Palliative medicine 2002 9(2):75-77.

Through the looking glass, darkly: palliative medicine in children RDW Hain. Welsh Journal of Paediatrics 2001; 14: 9-11.

Pain scales in children: a review RDW Hain. Palliative Medicine 1997; 11:341-350

Symptom control in dying children. RDW Hain, A Goldman. Prescriber 1995; 6(2):31-36

Published letters

Palliative medicine – Specialist Territory ? Journal of Royal Society of Medicine 1999 92(2):101

Examiners under scrutiny, Hospital Doctor 20 Nov 1997:20

Children and Smacking, British Medical Journal 2000 320:1538

Symptoms in dying children, Journal of Cancer Care 1994 3:221


Editor: Oxford Textbook of Palliative Care for Children (Second Edition) Ann Goldman, Richard Hain, Stephen Liben Oxford University Press, Oxford, 2012. ISBN 0199595100 (winner of BMA award for best paediatric textbook of 2013)

Author: Paediatric Oncology Group of Ontario Guideline for Classification of the Acute Emetogenic Potential of Antineoplastic Medication in Pediatric Cancer Patients L. Lee Dupuis, Sabrina Boodhan ,Lillian Sung, Carol Portwine, Richard Hain, Patricia McCarthy, Mark Holdsworth

Author: Oxford handbook of paediatric palliative medicine
Oxford University Press Hain, RDW and Jassal, S. 2010 ISBN 978-0-19-923632-9

Editor: Oxford Textbook of Palliative Care for Children Goldman, A., Hain, R.D.W. and Liben S. eds, Oxford University Press 2006. ISBN 0198526539 (winner of Royal Society of Medicine/Society of Medical Writers First Prize, 2006)

Author: Paediatric palliative care guidelines Lidstone, V., Delaney, J., Hain, RDW., Jassal, S. SW London, Surrey, W Sussex & Hampshire, and Sussex Cancer Networks

Book chapters

Chapter : Palliative care in The Science of Paediatrics: MRCPCH Mastercourse. Tom Lissauer, Will Carroll eds. Elsevier Health Sciences 2016. ISBN 10 0702063134, ISBN13 9780702063138

Chapter: Ethics in Paediatric Palliative Care in Oxford Textbook of Palliative Medicine. Nathan Cherny, Marie Fallon, Stein Kaasa, Russell K. Portenoy, David C. Currow eds. Oxford University Press 2015. ISBN10 0199656096, ISBN13 9780199656097

Chapter: Pharmacological approaches to pain. 1: ‘By the Ladder’ in Oxford Textbook of Palliative Care for Children (Second Edition). Ann Goldman, Richard Hain, Stephen Liben Oxford University Press, Oxford, 2012. ISBN 0199595100

Chapter: Pharmacological approaches to pain. 2: Simple analgesics and opioids in Oxford Textbook of Palliative Care for Children (Second Edition). Ann Goldman, Richard Hain, Stephen Liben Oxford University Press, Oxford, 2012. ISBN 0199595100

Chapter: Education in Oxford Textbook of Palliative Care for Children (Second Edition). Ann Goldman, Richard Hain, Stephen Liben Oxford University Press, Oxford, 2012. ISBN 0199595100

Chapter: United Kingdom in Pediatric Palliative Care: Global Perspectives. Springer 2011 (Knapp, Madden eds).

Chapter: Holistic Management of Symptoms in ‘Palliative Care for infants, children and adolescents: a practical handbook’. The Johns Hopkins University Press 2011 Brian S Carter and Marcia Levetown eds) Second edition

Chapter: Neurological symptoms in Textbook of Interdisciplinary Pediatric Palliative Care. Elsevier 2010 (Wolfe, Hinds, Sourkes eds) ISBN 978-1-4377-0262-0

Chapter: Cancer pain in children in Cancer Pain: Assessment & Management, Second Edition (Bruera and Portenoy eds), Cambridge University Press 2009 ISBN-13: 9780521879279

Chapter: Palliative care: moving forward. in Ethical, Legal and social Aspects of Child Healthcare.. Hain, R., Friedrichsdorf, S. (Cartlidge,P ed). Elsevier. 2007 pp 137-40.

Chapter: Communications skills in RCPCH Masterclass (Levene ed) Elsevier. 2007

Chapter: Pain and opioids in children in Textbook of Palliative Medicine (Bruera, E., Higginson, I.J., Ripamonti, C., von Gunten, C.F. eds), Edward Arnold 2006, p. 458 ISBN-10 0340810 181

Chapter: Education and training, Furguson L, Fowler-Kerry S, Hain R, in Oxford Textbook of Pallitive Care in Children (Goldman A, Hain R, Liben S eds) Oxford University Press 2006 pp594-614. ISBN 0198526539.

Chapter: Skin Symptoms, Watterson, G., Denyer, J., Hain, RDW. , in Oxford Textbook of Pallitive Care in Children (Goldman A, Hain R, Liben S eds) Oxford University Press 2006 pp448-459. ISBN 0198526539.

Chapter: Pain – pharmacological management, Drake, R., Hain, RDW., in Oxford Textbook of Pallitive Care in Children (Goldman A, Hain R, Liben S eds) Oxford University Press 2006 pp304-341. ISBN 0198526539.

Chapter: Whose dying is it anyway? Palliative care in adolescence. In Cancer and the Adolescent, 2nd edition edited by Eden TOB, Barr RD, Bleyer A and Whiteson M.Blackwell Publishing, 2005, pp 203-213. ISBN-10: 0727918109; ISBN-13: 9780727918109.

Section editor/author: Holistic Management of Symptoms in ‘Palliative Care for infants, children and adolescents: a practical handbook’. The Johns Hopkins University Press Brian S Carter and Marcia Levetown eds) 2004 pp 163-195.

Chapter: Palliative care in paediatric oncology, RDW Hain and J Hardy in ‘Paediatric Oncology’, 3rd edition (Ross Pinkerton, Piers N Plowman and Rob Pieters eds) Arnold Publishers 2004 pp 684-703, ISBN 0 340 80775.

Chapter: Oral care in paediatric oncology, Hain RDW, Roberts, G, Lucas VS, in Oral Medicine in Advanced Disease, Oxford University Press (Finlay, I., Davies, A eds). 2005, ISBN 0-19-263243-4..

Chapter: Pain in Children with Cancer in Psychosocial Aspects of Pediatric Oncology (Shulamith Kreitler and Myriam Weyl Ben Arush eds) Wiley 2004, pp 71-91 (SBN 0 471 49939 0).

Chapter: Palliative medicine and symptom control. In ‘Medicines for Children’, Royal College of Paediatrics and Child Health (eds Carson, D. et al) 2003.

Chapter : Pharmacological management of painful procedures in childhood cancer. In: ‘Paediatric procedure-related pain: nature, assessment and management’. Liossi, C. ed Radcliffe Medical Press, Oxford, 2001 (ISBN 1-85775-453-0)


Fellow, Royal College of Physicians (Edinburgh)
Fellow, Royal College of Paediatrics and Child Health
Together for Short Lives


Occasional for drug companies
Occasional expert witness reports


See above

Areas of Expertise

Opioid pharmacology in children
Ethics at end of life

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