Awareness of Death Among Children: Does a Life‐Threatening Illness Alter the Process of Discovery?

The authors review studies on death awareness among children who are healthy, chronically ill, and terminally ill. The review suggests that children with life‐threatening diseases demonstrate increased understanding of death compared with children who are either healthy or chronically ill. In particular, children with terminal illness, especially during the end stage of their disease, show an advanced understanding of the death concepts of irreversibility and finality. In contrast, healthy and chronically ill children appear to require certain age, cognitive developmental level, or intelligence thresholds to understand these concepts. Possible explanations for the findings in this literature are discussed. The implications of death awareness research for counselors are used as a base for suggesting counseling strategies.