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Seema Khaneja, MD; Barbara Milrod, MD

Arch Pediatr Adolesc Med. 1998;152:909-914.

Background  According to the Accreditation Council on Graduate Medical Education and the Ambulatory Pediatrics Association, pediatricians need to be instructed in caring for terminally ill children as a part of residency training. However, a systematic approach to education in end-of-life care is lacking in most residency programs.

Objectives  To assess pediatricians' self-perception of their coping skills regarding death and dying at The New York Hospital–Cornell Medical Center, New York City, NY, if they felt further support and education were needed in this area, and which modes of instruction respondents thought would be most useful.

Methods  Data based on a questionnaire distributed to pediatricians at The New York Hospital are presented.

Results  The following topics are discussed: (1) existing level of education and support in caring for terminally ill patients; (2) attitudes of pediatricians regarding discussions of diagnosis and prognosis with dying children and their families; (3) pediatricians' perceived need to limit emotional involvement with terminally ill children; (4) attendance of funeral or memorial services of patients by pediatricians; (5) experience of patient death as a failure; and (6) expressed need for support and instruction in death and dying based on level of training.

Conclusion  Educational interventions and support in this area are needed.

From the Department of Pediatrics, New York Methodist Hospital (Dr Khaneja), and the Department of Psychiatry, The New York Hospital–Cornell Medical Center (Dr Milrod), New York City.

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