Talking about death with terminally ill children: A challenge for doctors and parents alike

'I had no clue how many benefits there'd be' parent says

Having end-of-life conversations with terminally ill patients is difficult—but it's even harder when the patient is just eight years old, Bob Tedeschi writes for STAT News.

Some parents view such discussions as equivalent to giving up hope—but having them is ultimately helpful for all involved when children are sufficiently old to be able to understand the idea of death and are open to discussing the subject, pediatric specialists tell STAT.

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Terminally-ill children are often thinking about death before their parents broach the conversation, says Jennifer Mack, a pediatric oncologist at the Dana-Farber/Boston Children's Cancer and Blood Disorders Center. "It's just that the topic hasn't been given any air," she adds.

Bringing the conversation out in the open can empower children to speak up about their preferences, such as if a child wants to die at home and what he or she wants to wear during a wake.

We need to modernize America's end-of-life system

Paula Skelley tells STAT that end-of-life conversations helped her daughter Lydia chose her burial place and her casket before she died at age nine.

"After Lydia died, I was not faced with horrendous choices to make while in the depths of despair," Skelley says.

"I'd never blame anybody who hasn't talked to their child about it," she adds, "but I had no clue how many benefits there'd be" (Tedeschi, STAT News, 1/27).

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