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Book and Media Reviews
October 17, 2012

Speaking Honestly With Sick and Dying Children & Adolescents: Unlocking the Silence

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Contributing Editor.

Author Affiliations: Department of Emergency Medicine and Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor (arbmph@umich.edu).

JAMA. 2012;308(15):1588. doi:10.1001/jama.308.15.1588

My first exposure to breaking bad news came at the beginning of my third-year clerkships, as the medical student member of a team caring for a 12-year-old boy who had been diagnosed with an aggressive malignancy. I was fortunate to have been on the service of an astute, compassionate, and insightful attending physician and was privileged that my initiation into this type of discussion was modeled by such a dynamic and kind clinical teacher. Although our young patient might have been considered too young by some physicians of the time to have engaged in a frank and honest conversation about his diagnosis and its implications, the empathy, sincerity, and respect shown by this child's physician exposed me to a practice not fully endorsed at the time: being honest with young patients about dying. Nearly 4 decades have passed, and although physician practice surrounding this topic has changed considerably, controversy remains regarding truthfully communicating issues of death and dying with terminally ill children and adolescents.

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