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American Journal of Hospice and Palliative Medicine®
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Choreographing the End of Life in a Neonate

Jay M. Milstein, MD

Department of Pediatrics, Division of Neonatology, University of California, jmmilstein{at}ucdavis.edu

Bonnie Raingruber, RN, PhD

Departments of Nursing Research and Internal Medicine University of California

As caregivers, we often have the privilege of accompanying patients and their families at the end of life. When the patients are newborn infants, the parents are totally unprepared cognitively, emotionally, and spiritually. Their experience represents uncharted territory. The concept of uncharted territory probably applies to everyone facing the death of a loved one for the first time for both the patients and their families. Providing some guidance to patient/family dyads, while simultaneously respecting their autonomy, may be helpful to facilitate healing and meaning construction during the process of bereavement. In applying an integrative universal paradigm of care when curative measures elude us, healing measures become of paramount importance. An exemplar involving a neonate is presented in this commentary; however, healing measures are relevant to patients of all ages as well as to their loved ones.

Key Words: end-of-life care • paradigm of integrative care • neonate • bereavement • healing

American Journal of Hospice and Palliative Medicine®, Vol. 24, No. 5, 343-349 (2007)
DOI: 10.1177/1049909107305645


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J. M. Milstein
Introducing Spirituality in Medical Care: Transition From Hopelessness to Wholeness
JAMA, May 28, 2008; 299(20): 2440 - 2441.
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