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Palliative Care, Dying, and Bereavement

Frederick P. Rivara, MD, MPH; Chris Feudtner, MD, PhD, MPH

Arch Pediatr Adolesc Med. 2008;162(8):789.

As physicians, one of the hardest tasks for which any of us is called on is helping a pediatric patient and his or her family with the passage from life to death. In 2005 in the United States, 53 501 infants, children, and adolescents died. Some occurred suddenly and unexpectedly, after trauma or owing to sudden infant death syndrome, for example. Others occurred because of premature birth or a fulminant infection. Still others are the result of a chronic disease for which a cure is not available, such as refractory cancer or neurodegenerative conditions, and where death often occurs after a prolonged course of illness during which care shifts from aggressive life-prolonging treatment to devoted palliative care aiming to enhance quality of life and minimize suffering.

Many children are also faced with bereavement after the loss of a sibling or parent. Of those 53 501 children who died, many had siblings who will now have the loss of a beloved brother or sister as part of their lives, their personal histories. In addition, 2005 witnessed the death of 330 771 individuals aged 20 to 54 years, many of whom were parents, and thus left behind young children and teenagers.

The editors and editorial board of Archives of Pediatrics and Adolescent Medicine recognize the importance of the myriad issues embedded in the scenarios described above. We have therefore decided to have a rolling theme issue in the Archives this year on palliative care, dying, and bereavement. We are interested in original articles, narrative and systematic reviews, and commentaries that will add to the scientific knowledge about these topics. Such articles might include observational longitudinal studies, such as the effects of the loss of a family member on children and adolescents, clinical trials examining specific interventions or evaluating different systems of delivering palliative, hospice, or bereavement care, and ethical analyses regarding how we decide on and enact the goals and limits of medical therapy.

Our intent is to bring these issues to the forefront of pediatrics and adolescent medicine, just as they are in the minds of those children and families who are confronted with such loss. We hope the attention of the Archives will advance science and provide help to physicians dealing with these issues on behalf of their patients and families.

This call for papers will be ongoing, and we intend to publish articles on this topic throughout the year as the manuscripts are submitted and accepted. For specific guidelines on manuscript preparation and submission, please consult the author instructions on our Web site at www.archpediatrics.com. Authors should indicate in their cover letter that the manuscript is to be considered for this theme.

AUTHOR INFORMATION
Correspondence: Dr Rivara, The Child Health Institute, University of Washington, 6200 NE 74th St, Ste 110, Seattle, WA 98115-8160 (fpr{at}u.washington.edu).

Financial Disclosure: None reported.