TY - JOUR
T1 - Coping With Poor Prognosis in the Pediatric Intensive Care Unit
T2 - The Cassandra Prophecy
AU - Waller, David A.
AU - Todres, I. David
AU - Cassem, Ned H.
AU - Anderten, Ande
PY - 1979/11
Y1 - 1979/11
N2 - The intensive-care pediatrician who prophesies to parents that their child's illness is irreversible may encounter denial and hostility. 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. Four cases are reported in which parents rejected their child's hopeless prognosis, counterprophesied miraculous cures, resolved to obtain exorcism, criticized the care, or accused nurses of neglect. This produced a painful breakdown in the usually harmonious relationships between doctors, nurses, and parents. Parental denial as a coping mechanism is discussed. Guidelines are presented for the prevention and/or early recognition and management of the Cassandra Prophecy phenomenon. A miraculous recovery in one case is a potent reminder to physicians and nurses that they do not have the gift of divine prophecy and cannot see with certainty into the future.
AB - The intensive-care pediatrician who prophesies to parents that their child's illness is irreversible may encounter denial and hostility. 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. Four cases are reported in which parents rejected their child's hopeless prognosis, counterprophesied miraculous cures, resolved to obtain exorcism, criticized the care, or accused nurses of neglect. This produced a painful breakdown in the usually harmonious relationships between doctors, nurses, and parents. Parental denial as a coping mechanism is discussed. Guidelines are presented for the prevention and/or early recognition and management of the Cassandra Prophecy phenomenon. A miraculous recovery in one case is a potent reminder to physicians and nurses that they do not have the gift of divine prophecy and cannot see with certainty into the future.
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U2 - 10.1001/archpedi.1979.02130110029002
DO - 10.1001/archpedi.1979.02130110029002
M3 - Article
C2 - 507004
AN - SCOPUS:0018594335
SN - 0096-8994
VL - 133
SP - 1121
EP - 1125
JO - American Journal of Diseases of Children
JF - American Journal of Diseases of Children
IS - 11
ER -