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

1. A baby has died and the parents look to you, the doctor, for guidance as to what happens next. It may seem that nothing more can be done, that you as the doctor have failed. The parents appear shocked and unable to grasp what has happened. Do you…

a) Acknowledge how distressing this must be for them and advise them to go home to their family for comfort and support in their own environment.

b) Acknowledge the sadness of the situation and allow the parents to see your sadness. Make suggestions, offering them choices as to what they might like to do next for their dead baby, with or without you.

c) Tell them you know how they feel and that it is best to limit the time they spend with their dead baby as it may be too difficult to let go later.

2. A child in your care has died after being in hospital for a week and you are aware there are siblings aged 3 and 5 who are at home with grandparents. The parents are unsure as to what is appropriate for their other children. Do you…

a) Explain that children can be included around the death of their sibling, but that it is inadvisable for ones so young.

b) Explain to the parents that children of this age have little understanding of death and are best at home, away from the sadness of the situation and protected from the depth of their parents’ raw feelings

c) Say to the parents that it is natural to want to protect children from such sad situations, but children pick up much more than we give them credit for. Children who are included and told what to expect generally manage well, only tending to make up what they are not told.