Skip to main content

Coping with Poor Prognosis in the Pediatric Intensive Care Unit

The Cassandra Prophecy

  • Chapter
Coping with Physical Illness

Abstract

When the pediatrician in a hospital intensive care unit (ICU) predicts to parents that a poor outcome is likely, he may sometimes encounter disbelief and even animosity. “We’ve told the parents their child’s chances for a healthy recovery are extremely poor, but they don’t appear to understand—they seem to be totally unrealistic” was a comment not infrequently made by pediatric medical staff and nursing staff in our pediatric intensive care unit. The physician may compare his plight to that of Cassandra—the mythical Greek prophetess of doom, who was cursed to see into the future and not be believed. The purpose of this report is to describe the Cassandra prophecy phenomenon and to present our hypotheses about its meaning and how it might be dealt with effectively.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Richmond, J. B., & Waisman, H. A. Psychologic aspects of management of children with malignant diseases. American Journal of Diseases of Children, 1955, 89, 42–47.

    PubMed  CAS  Google Scholar 

  2. Weisman, A. D., & Hackett, T. P. Predilection to death: Death and dying as a psychiatric problem. Psychosomatic Medicine, 1961, 23, 232—256.

    PubMed  Google Scholar 

  3. Friedman, S. B., Chodoff, P., Mason, J. W., & Hamburg, D. A. Behavioral observations on parents anticipating the death of a child. Pediatrics, 1963, 32, 610–625.

    PubMed  CAS  Google Scholar 

  4. Oken, D. The doctor’s job: An update. Psychosomatic Medicine, 1978, 40, 449—461.

    PubMed  Google Scholar 

  5. Siegler, M. Pascal’s wager and the hanging of crepe. New England Journal of Medicine, 1975, 295, 853–857.

    Article  Google Scholar 

  6. Solnit, A. J., & Stark, M. H. Mourning and the birth of a defective child. Psychoanalytic Study of the Child, 1961, 16, 523–537.

    Google Scholar 

  7. Weisman, A. D., & Hackett, T. P. Denial as a social act. In S. Levin & R. Kahana (Eds.), Geriatric psychiatry: Creativity, reminiscing and dying.New York: International University Press, 1966.

    Google Scholar 

  8. Superintendent of Belchertown State School vs. Saikewicz,—M:BS—, 370 NE 2d 417, 1977.

    Google Scholar 

  9. Caplan, G. Practical steps for the family physician in the prevention of emotional disorder. JAMA, 1959, 170, 1497–1506.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1984 Plenum Publishing Corporation

About this chapter

Cite this chapter

Waller, D.A., Todres, I.D., Cassem, N.H., Anderten, A. (1984). Coping with Poor Prognosis in the Pediatric Intensive Care Unit. In: Moos, R.H. (eds) Coping with Physical Illness. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-4772-9_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-4684-4772-9_16

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-4774-3

  • Online ISBN: 978-1-4684-4772-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics