Assisting natural process

Dying well. Something we all probably want to happen. And to witness or know with our loved ones. In thinking about a possible career move into palliative care, I began to think of this professional role as being like that of a midwife. Assisting with a natural process, using knowledge, skill and experience to work together with all those affected to manage a transition. From one stage of being to another. A role of privilege and of responsibility.

In my previous role in child rights advocacy I read a national review which found that there was inconsistent access to palliative care services for children and their families. On a population level this is not a 'common' health need, but it is one of those areas of health and wellbeing where the impact of the situation means that it is a priority.

So I was pleased to see this month that the editors and editorial board of the journal Archives of Pediatric and Adolescent Medicine have decided to have a rolling theme issue on palliative care, dying and bereavement. Dr Rivara says:

Our intent is to bring these issues to the forefront of pediatrics and adolescent medicine, just as they are in the minds of those children and families who are confronted with such loss. We hope the attention of the Archives will advance science and provide help to physicians dealing with these issues on behalf of their patients and families.

On a global scale of course there are many many more children who die needlessly. Their need is not for palliative care. But for the basics of clean water, food, or protection from preventable communicable disease. And for far too many the prerequisites of the basics - life free from conflict, war and environmental degradation. Despite recent improvements, over 26,000 children aged under five still die every day. I cannot rejoice that the annual toll has 'fallen' to 9.7 million.

Yet these are not mutually exclusive issues that we face. Our children have the right to be fully considered as nations make decisions about their health expenditure. AND our children have the right to be fully considered as all nations make decisions about expenditure. On weapons. Or water.