In his letter to the editor, Dr Nitschke raises an important point regarding informing a child of his or her impending death. Although not reported on directly in our article, we did ask parents whether their child was informed of his or her impending death. Many parents cited that their child was too young to talk about the fact that he or she was dying. Other parents stated that they themselves were emotionally unable to raise the issue. Some parents expressed regret at not having had these discussions with their child and were tortured by thoughts about potential fear and anxiety the child might have faced. A few parents were able to talk directly with their child and give him or her the opportunity to choose how to spend what time was left. These situations were the exception rather than the rule. In addition, it seemed rare that someone other than parents talked to the child about dying.
Contro N. Palliative Program Considerations. Arch Pediatr Adolesc Med. 2003;157(2):208. doi:10.1001/archpedi.157.2.207