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July 22, 1968


JAMA. 1968;205(4):238. doi:10.1001/jama.1968.03140300056015

Caring for a dying child and his family is one of the most oppressive tasks to confront a physician. The performance of this task depends more on perceptiveness and intuitive response than on a set of rigid textbook instructions—which, one might add, are notably scarce. There are, however, times when the physician, left to his own devices, may feel the need of guidance. A number of enlightening communications in the pediatric and general medical literature provide insights into the behavior of the dying child and his parents.

Some behavioral patterns, observed by Friedman et al1 in parents of dying children, make it clear that the physician must often devote as much care and time to the parents as to the victim. Parental guilt, denial of reality, remorse, anger, and paradoxical detachment are emotional responses which must be understood to be competently handled. In their poignant "If a Child Must