The Pediatrician and the Handling of Terminal Illness

There is little in our medical training which prepares us as pediatricians to deal with the problems attending the death of our patients. Our emphasis has rightly been on the maintenance of life and growth. While over-all pediatric mortality decreases, there is an increasing segment of the patient population with chronic illness such as leukemia, cancer, and cystic fibrosis that can be expected to be terminal. Inevitably, the handling of the terminal phases becomes the responsibility of the physician who is most knowledgeable about the disease, usually the pediatrician, who has had no preparation for dealing with the delicate interpersonal problems and processes involved.