Content area
Full text
T he death of a child brings profound distress and intense grief to the family, challenging all those involved in caring for the family through such times. That such grief can lead to suicide is known, but two cases in this week's BMJ show a particular hazard after a child has died at home: in both cases mothers committed suicide with drugs prescribed for the palliative care of their children ( p 647 ). 1
There is substantial evidence from comparative and longitudinal studies that the grief of parents following the loss of a child is more intense and prolonged than that of other losses. 2 3 Parental vulner-ability includes a heightened risk of suicide, especially in the first month, as shown in a nested case-control study of Danish longitudinal registers. 4 Population based follow-up studies also show that anxiety and depression may last four to nine years after the loss of a child from cancer. 5
When a child dies suddenly-for instance, through suicide, homicide, violence, or accidental death-parental grief may become complicated by post-traumatic stress reactions arising from the nature of these circumstances, so that the parent has to deal with the interplay of both trauma and grief. 6
The challenges that arise when a death is prolonged are different. Caring for a child with chronic fatal disease such as cancer may involve intense and prolonged treatments; the sustaining of hope; the denial of the potential for death as the parent fights for the child's survival in a protracted battle with the disease. Anticipatory...