Tell the Children

Article Tools ART OF ONCOLOGY: WHEN THE TUMOR IS NOT THE TARGET Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2000.18.17.3193 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 10963650 Tell the Children Joanne M. HildenxJoanne M. HildenSearch for articles by this author , Jan WattersonxJan WattersonSearch for articles by this author , Jody ChrastekxJody ChrastekSearch for articles by this author Peter M. Anderson, MD, PhDxPeter M. AndersonSearch for articles by this author Show More From the Department of Hematology/Oncology, Children's Hospitals and Clinics; and Children's Home Care and Hospice, St Paul, MN. https://doi.org/10.1200/JCO.2000.18.17.3193 First Page Full Text PDF Figures and Tables © 2000 by American Society of Clinical OncologyjcoJ Clin OncolJournal of Clinical OncologyJCO0732-183X1527-7755American Society of Clinical OncologyEDITORIAL COMMENTARY17092000 This article nicely illustrates the vast difference between two different approaches to "tell the children." Each has different results in terms of stress level and psychologic health of not only children but their siblings in dealing with a difficult situation, that being the death of a child from cancer. It seems the very style of scientific writing asks us as physicians to be rational—even when confronted with the hard facts of life and, unfortunately, death of children. This is especially hard to do with children, because we've become so close—not only as parents, but also as care providers. Pediatric oncologists and care staff often reach a point of psychologically accepting the death of a patient as inevitable. When such a point is reached before the parents and/or other members of the family reach this point, conflict can easily arise. If perceptions of the inevitability of death, however, are congruent, less conflict is apt to occur, as very nicely illustrated in the second of the two case vignettes. This article also very nicely shares comparison and contrast about honesty. Honesty is the best policy with children of all ages. This way, the reality of the situation, no matter how awful it is, can be shared in an open manner. In trying to protect children from knowledge about what's happening, they often can become even more confused and overly concerned about things that are beyond control. Finally, it is wise as care providers to "share the burden"; these case vignettes illustrate how, in a modern multidisciplinary clinic with support from child family life, hospice, as well as pediatric oncology and nursing, many individuals can make a difference—no matter what the outcome. This is where the art of oncology becomes especially difficult but is extremely important. Patients who cannot be cured need our services as well! Pediatric Oncology Mayo Clinic Rochester, MN Financial support for this work was provided by the Pine Tree Apple Tennis Classic Oncology Research Fund, St Paul, MN.