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Reflections on death in childhood.

1987; BMJ; Volume: 294; Issue: 6564 Linguagem: Inglês

10.1136/bmj.294.6564.108

0959-8138

F Dominica,

Ethics and Legal Issues in Pediatric Healthcare

During the past four years I have been involved in varying degrees in the death of about 70 people, most of them children and teenagers. Almost anything worth while that I have learnt about death, I have learnt from those young people and from those closest to them. Perhaps the most important thing has been the gradual recognition that however ill at ease and maladroit Western society is in the face of death, given permission and a loving, affirming environment, the individual will meet death with what I can describe only as a severe beauty. Death is familiar to us in war, in holocaust, and in massive famine disasters, but we know it as remote control statistics. Death is no longer the familiar part of the domestic neighbourhood scene that it was 100 or even 50 years ago. Improved living conditions, health care, and highly developed skills in medicine and surgery, the breakdown of the extended family and the close knit local community, the tendency for the fatally ill, even the elderly, to be taken away to hospital or institution, all contribute to an unfamiliarity with death. Many people will reach middle age without ever having been in the presence of death and possibly without having attended a funeral. The more sophisticated our society becomes and the more it pays homage to intellect and powers of reasoning the more ill at ease it is with death and that which lies beyond. Religion, belief in that which cannot be proved, and the readiness to allow ourselves to be led beyond our ken into the realms of mystery are things less and less to be trusted. Sometimes those who wield the greatest power and possess the greatest wealth are those who fare worst for here, finally, is something which neither money nor position can win back?life itself.