Wednesday, June 21, 2006

Sudden Death in Children

JAMA has continued the wonderful Perspectives on Care at the Close of Life series with a recent article on Sudden Traumatic Death in Children. The subtitle is quite moving. "We Did Everything, but Your Child Didn't Survive."

The article is well written with perspectives from a physician and social worker involved in a case of an 18 month-old hit by a car. One interesting aspect is the criteria for brain death in children are age-specific, a fact I was not aware (probably having to do with my Internal Medicine background). What surprised me was the robust bibliography (60+ articles) on a subject that does not always get a lot of attention. Of course I hear about cases like this a lot, but not because of my hospice background, but because my wife is a Pediatric Emergency Medicine Fellow (almost done!). When people hear I work at a hospice they often comment on how 'sad it must be.' But from the stories I hear from my colleagues in the Pediatric Emergency Department, I have realized there are more difficult medical cases. So I am glad to see articles like this one to help people like my wife and her peers have some structure to such a difficult situation. Like the physician in the article says:

"'s like you're trying to have a funeral organized and go on time, in the context of a busy ICU. That's very difficult to have come out well."

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