The dying child and the family

The physician involved in the care of a child with a fatal disease has an obligation not only to give the best possible medical care to the child but also to provide emotional support and guidance for the family and the patient. Many emotional problems can be resolved or prevented by discussions with the parents and by encouraging them to express their anxieties and questions. The death of a child is the ultimate tragedy, and everything should be done to prevent further problems which add to the anguish the parents must endure. Support of the parents begins when the diagnosis is first presented, must be continued throughout the child's course, and should often extend beyond the death of the child. Understanding the child's reactions to death is important and helps the physician respond appropriately to the child's questions. Some older children wish to discuss their disease with the physician and in such cases their questions should be answered honestly, while at the same time offering hope.