When a baby or child is dying, your medical skills, experience and caring attitude are stretched to the full. Sometimes nothing more can be done to prevent the death. That’s when another part of your role begins…

The way you communicate with parents when their baby or child is not expected to live can make a significant difference. In this situation, the family is bound to be deeply distressed. Whatever you say or do cannot take away their distress, but you can make a difference by your humanity, your sensitivity, your language and your actions – and this will be remembered forever.

Think through the following three scenarios and how you might respond:

1. A child under your care suddenly collapses and is not expected to live. The parents arrive at the hospital in the midst of the crisis of resuscitation and want to see their child. You feel they are so distressed that it would be difficult for all involved to have them there. You and the nurses are deeply distressed by the situation, and you wish to protect the parents from similar feelings. Do you…

a) Tell them that, in your professional opinion, it would be too distressing for them to be in the resuscitation room, and that you would not permit it.

b) Tell a nurse to persuade them that it’s in their best interests not to see the child – it would only make a bad situation harder to manage.

c) Ask a nurse to explain what is likely to be happening, and to offer the parents support to come into the resuscitation room with you and see their child anyway.

2. In the same situation, you are with the parents as they face a decision as to whether or not treatment should be continued. Clearly, you are responsible for explaining the situation to the parents. Do you…

a) Listen to their concerns, answer their questions and work towards a joint decision.

b) Explain to them that the decision is theirs. Tell them what you believe is best. Allow them to ask questions, and give them clear, considered answers.

c) Remove the burden of the decision from the parents by giving them your considered medical opinion and telling them what course of action is best for their child.

3. When dealing with both parents at the same time, is it more appropriate to…

a) Give the information to the father who is likely to be less emotional and better placed to support the child’s mother.

b) Explain the information to both the mother and father and ask them what they understand.

c) Give brief information equally to both parents and leave a member of the nursing staff to support them.