[The children of the Valley of Death--reflections on terminal children].
The author ponders on the role of the pediatrician facing the death issue and its philosophical and existential implications. The author also ponders on the death issue in todaýs culture, as well as the transformation undergone by exequies, and modern man's death in the loneliness of emergency rooms, where he dies technologically well assisted but in a lonely, impersonal environment far away from his loved ones, and deprived of the sheltering warmth of his home. The author considers the difficult task of revealing a diagnosis and prognosis of a terminal illness to the patient's family and to the patient himself. He studies the several stages of such a revelation and offers an extensive bibliography of the literature concerning the issue. He judges the terminal patient's family's different reactions to the revelation, from the search for impossible miracles through wonderworkers and charlatans to the confrontation of natural products and magical fluids with scientific knowledge. He considers the role of the pediatricians in finding a solution to the dialectics of his own death, for only by doing so will the pediatrician be able to competently and maturely handle the challenge represented by the death of his terminal patients. He finishes by drawing attention to the importance of psychological assistance to the terminal child and its family.
Pinto
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LF
Comitê de Saúde Mental da Sociedade de Pediatria da Bahia, BA, Brazil.