Educational Needs Among Pediatricians Regarding Caring for Terminally Ill Children

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Abstract
THE DEATH of a patient is known to be a stressful experience for physicians.1,2 The death of a child is even more disturbing because it contradicts the natural order of things: children are not supposed to die.1,3 Nevertheless, pediatric residents care for a significant number of terminally ill children during their training.4-6 In 1983, Sack et al6 interviewed third-year pediatric residents at 4 western US university training programs about their experiences in caring for dying children. The authors reported that pediatric house officers cared for an average of 35 dying children during their first 21/2 years of residency training. With the development of increasing technology in neonatal and pediatric critical care, as well as the growing numbers of children with acquired immunodeficiency syndrome, one can speculate that this number is even greater today. In addition, the secularization and institutionalization of death has meant that fewer societal support systems exist to facilitate bereavement. Increasingly, patients and families turn to health care professionals for support and comfort during this time.3,7,8

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