A Fault In Our Stars - one of last year's most successful children's paperbacks.

London - As plots go, it’s mawkish at best, exploitative at worst. Diagnosed with stage four thyroid cancer at the age of 13, Hazel spends most of her time tethered to an oxygen tank and is running out of hope.

When she is attracted to a fellow cancer sufferer, she has to weigh up if she has enough time to fall for him before she dies.

Such is the storyline of A Fault In Our Stars, one of last year’s most successful children’s paperbacks.

It’s a scenario seen again in Never Eighteen, also published last year, in which leukaemia-stricken Austin, 17, is in a race against time to tell his best friend he loves her because he doesn’t expect to see his next birthday.

Coincidence? Hardly. Another children’s novel — Before I Die — about a 16-year-old British girl who, you will have guessed, is dying of cancer, has been made into a Hollywood film, starring Twilight and War Of The Worlds star Dakota Fanning.

According to the blurb, Tessa compiles a list of what to do before she expires: “Number one is sex. Starting tonight.”

It’s not just the fact that these books feature terminally ill teenagers that makes them so questionable — they’re also aimed at children as young as 12.

Since the vampire book bubble burst, publishers have been looking to find the next big thing in the lucrative world of young adult fiction.

Indeed, A Fault In Our Stars, published by Penguin, spent half of last year at the top of Amazon’s teen best-sellers list. Before I Die sold 70,000 copies in its first four months.

While the Twilight series and its imitators are clearly fantasy, these books don’t spare any detail of the harsh realities of terminal illness, depression and death.

Most are also liberally peppered with sex and swearing. The blurbs for “teen sick-lit” — as it’s become known — trip over themselves to promise their books will drive readers “to tears” or leave them”devastated”.

As if using children with months to live to build dramatic tension is not distasteful enough, the taboo about writing about suicide in young adult fiction has also been broken by the book Thirteen Reasons Why — a bestseller about a teenage girl who leaves 13 recordings explaining why she killed herself.

While the media stops short of reporting even the most basic facts of suicide for fear of encouraging copycat behaviour, publishers are commissioning entire works of fiction on the subject.

Such novels include By The Time You Read This, I’ll Be Dead, published by Disney and Hyperion Books for Children. It centres on a disturbed schoolgirl, who, after a string of bungled attempts, uses a suicide website to set herself a deadline for achieving her goal.

It includes passages on the most effective ways of killing yourself. Though helplines are listed, at the end it’s left unclear if the central character decides to go through with it or not.

Children’s book expert Amanda Craig is among those concerned about these books. She has been sent about 12 teen sick-lit books over the past year, but she feels so strongly she will not review them.

According to Amanda, the bandwagon began with the success of books such as The Lovely Bones, in which a 14-year-old girl watches her family and friends from heaven after she is raped and murdered.

When the book became popular among young teens, publishers set about commissioning a raft of morbid novels, which all too often inadvertently glamourise shocking life-and-death issues.

“When you write for children, you have a moral and social responsibility,” says Amanda. “I think there is a cavalier attitude towards this in the publishing industry, especially as children as young as 11 are likely to be reading these books.

“They are aimed at young teens at the time when they are most likely to go through self-harm or experience suicidal thoughts.”

One book that stood out for Amanda is Red Tears — by British author Joanna Kenrick — about a girl who self-harms to cope with the pressure of her GSCEs. It was published by the children’s division of Faber.

“I know a girl of 12 in whose class the book spread like wildfire — several of them also started cutting themselves,” she says.

Indeed, the book’s website makes it clear it has come to be viewed as something of a classic by self-harmers. While many say the book has helped them, others write that it tipped them back into the habit. One girl, Jess, says that while the book put into words what she felt, “it was also too close to home for me to read”. She added: “I’d finish reading and immediately reach for my blade.”

While Laura Haddow of support group selfharm.co.uk says the book is “a very useful account”, she adds: “There’s often a fine line between raising the profile of the problem so that more young people can seek help versus presenting it as another option for young people to express how they feel.”

While she says she would give thebook to the family or friends of a self-harmer to help them understand the issue, she would be “very cautious about giving it to a young person to read alone”.

Julie Elman, of the University of Missouri, who has studied teen sick-lit, is worried the genre encourages young girls to believe that the most important thing to worry about when facing serious illness is whether boys still fancy them.

In a research paper, she cites one example, So Much To Live For, in which the central character, who has eye cancer, is traumatised she can’t wear make-up around her empty socket for fear of infection. One of the publishers at the forefront of the sick-lit trend is Penguin’s young people’s imprint Razorbill, which produces 40 books a year for children age 12 and up.

As well as publishing Thirteen Reasons Why, they have also published two teen cancer books, The Probability Of Miracles and The Fault In Our Stars, as well as Zoe Letting Go about a teen committed to an institution for eating disorders.

When the Mail approached Penguin, the firm declined to make a statement, but offered a comment from one of their writers Phil Earle, 39, author of Saving Daisy, in which the main character self-harms.

“When young people are lost in such traumatic states, it’s vitalthat they don’t feel alone,” he says.

“Isolation makes the situation worse and their problems more entrenched. Novels and stories on the subject offer a sense of commonality and, most importantly, a sense of hope.

“How do I know this? Because young people going through such trauma have told me so.”

Child psychologist Emma Citron urges parents to keep a careful eye on their children if they find they keep reading these books - particularly if they are under 15.

“I think there are more life-affirming ways for young people to find out about death,” she says. “It’s OK as along as parents are talking to them about these books and what they are thinking and feeling.

“But these subjects should not be consumed by young people alone.

“If they start to head them down a morbid path that makes them sink into a low mood, that is a significant worry.

“Parents should be vigilant if a child is reading a lot of thesebooks.”

So the next time your teen is curled up with a book, ask them what it’s about, says Emma.

“Let’s hope publishers do have young people’s interests at heart - and they are not selling books by sensationalising children’s suffering.” - Daily Mail