1957 Geloof en Wetenschap : Orgaan van de Christelijke vereeniging van natuur- en geneeskundigen in Nederland - pagina 253

RONDBLIK

210 5. Is it best to tell a child he is dying?

No. It is the practice in pediatrics never to tell the pediatric patient that he is going to die. A child does not comprehend death and often becomes frightened if you explain in terms he does not understand. However, this does not mean that the Gospel cannot be presented. Most important, a child can readily speak of Jesus and Heaven without associating them with pain, death, and separation from parents. The Scripture verses in the above discussion are quoted to start your train of thought; further Bible study will show you that they are by no means the only passages which deal with the topics. C.

The

Relatives

A most important aspect of management of the relatives is how to tell them that their loved one has a fatal illness. A primary rule is hat the diagnosis should not even be mentioned until all the preliminaries and diagnostic procedures are finished. Do no allow the relatives to know your thoughts and plans. Is does not help them to worry about several serious differential diagnoses rather than one even fatal possibility. When you are ready to discuss the diagnosis and the future plans, call the important family members together in a quiet private place where everyone can be seated. A convenient telephone and a box of Kleenex might be of help in making the minutes after your discussion pass smoothly. Explain the tests very briefly by saying, „It is our opinion on the basis of our study that your child (parent, etc.) has (whatever the disease may be)." Then wait and answer the questions with simple „yes", „no," „we cannot predict" answers. The patient's relatives do not tolerate a long discussion at first. The emotional response does not always come at once and often their minds are in a turmoil until it does. It is often kind if you leave them alone for a few minutes and return when they are steadier and can talk clearly with you. Then you might ask, „Do you have any questions?" or „Is there anything bothering you as to the cause of the illness?" or ,,What do you fear?" It is important to recognize that almost everyone, especially parents, feel guilty about a loved one's illness. They may remember attempting to abort the child or neglecting it, or they may blame the other parent or feel that the disease was inherited. It is our job as physicians to discuss their guilt feelings and to explain the cause of the illness if any. At the end of the first disusscion with the relatives leave them with something positive. Help them to return to the patient with control and a smile; in fact, urge them to do this. It is extremely important to plan with the relatives. The practice in pediatrics is to tell the parents as much as possible about the therapeutic medical or surgical regimen. Then their role as parents is explained: for example, to watch for bleeding, signs of infection, shortness of breath.

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