Tag Archives: Hospital Chaplaincy

Talking to Children about Death

Now that this semester is (for all intents and purposes) complete, I want to dedicate some effort to the blog. I have ideology critique on my mind as I have been reading a lot of Slavoj Žižek for a paper I wrote about ideology, irruptions of the Real, and interreligious care (who doesn’t love an alliteration!?), and there is another strand of Žižek that I have been thinking about and that is fetish disavowal with his apt comparison to belief in Santa Claus (there will be Christmas spoilers!). In the latest Journal of Psychology and Christianity there is an article about talking to children about death (“Talking to Children About Death”), which is going to be my focus today. There is nothing like talking about dying children to drive up blog traffic…

Full disclosure: I don’t have kids, so I am not suggesting how to parent or how not to parent. I am drawing on my experience as a pediatric chaplain that has dealt with numerous dying children from a myriad of illnesses ranging from cancer to neurological brain death. This is written from those conversations and those patients. I do not pretend to know how to parent; I am only offering my perspective on talking to children as they approach death.

The main premise of the article (I can send it to you, I think… I am not sure on those legal ramifications, but I am a millennial so since I’d burn you a CD… you get the picture) is that there is a correlation between talking to children about death and death anxiety. The article lays out the three ways to approach these conversations: Biological, religious/spiritual, and irreversibility of death. I am not as interested in those categories today, but I am interested in the how faith and anxiety affect our conversations about death.

I have sat in numerous family meetings with parents that are adamant that talking to their (adolescent) child about death will take away their hope and therefore speed up an already impending death. That is the parents perspective though. What about the child? What about the sixteen-year-old with cancer who has fought through chemotherapy for years? Both my experience and the peer-reviewed research show that children not only want to talk about it, but they already know at some level that something is different (whether they cognitively understand lab cultures or tumors, for example, is another blog!). Kids are incredibly perceptive and make meaning out of their environment whether or not they are informed directly. I am constantly amazed at what a child understands about their condition only through interpreting reality. So, where does Žižek come in? Although I might be reading Žižek against Žižek (i.e., I may be getting him WAY wrong), his example of how our belief in Santa Claus functions is helpful here.[1] Žižek’s critique is that, at some point, the child knows that Santa Claus is not real, but a creation of their parents, but they play along in order to uphold a level of belief to keep their parents happy; or, as Žižek said:

In short, they transfer their belief onto another. We do the same with our children. We go through the ritual of Santa Claus, since our children are supposed to believe in him and we do not want to disappoint them. They pretend to believe so as not to disappoint us and our belief in their naivety.[2]

There is a denial working on two levels: First, the child knows the reality but doesn’t want the parents to know that they know, and second the parents know but don’t want the children to know that they know.

In terms of human development, how can a chaplain stand in the gap? How can we talk to a child about his/her death, while honoring the parents wishes as guardians, and taking the patient’s developmental progress into account and still uphold the integrity of the family system? First, I think it is important to acknowledge that these conversations look differently to different people or different religious communities and differing ages of the patient. I have talked to late adolescents differently than a seven-year-old about death. Or I have learned what not to say through conversations with a Muslim family from Pakistan instead of Morocco. Don’t assume!

My favorite part of the article states, “the results indicate that parental death anxiety and belief in an afterlife played a unique role in parents choosing to use religious/spiritual explanations.” Yes! I can think of a specific example as I wind this post down. We had a patient that was nearing death. He had asked questions and expressed his fear of dying, but his family was clear that we were not to talk about death. Legally, we honor the parents/guardians, but ethically it was very difficult to essentially allow the patient to spiritually/emotionally suffer because the parents were against it. In my opinion, in that instance, the level of disavowal with the the parents. This story ends in death, and other stories end with parents beginning a conversation with the assistance of a chaplain, social worker, or another staff member.

I have had to learn to respect the process and respect where each family is on their specific journey. It does no good for me to destroy an existing family structure to do something that I think is important (what I think as a white, middle class, straight, Protestant… you get the picture…). My practice? I continually listen to families and encourage them to have the conversation. This conversations BEGINS before having the conversation. Think about death now parents! It is like the sex talk, be prepared because when emotion and anxiety enter the frame it will look different. I encourage words/phrases to use to begin a conversation and explain what they might receive in response. I am ready to have that conversation, but coming from a parent – or another trusted adult family member – is of more importance, in my opinion.


[1] Developed in Violence: Six Sideways Reflections (New York, N.Y.: Picador, 2008); and The Puppet and the Dwarf: The Perverse Core of Christianity (Cambridge, Mass.: The MIT Press, 2003).

[2] Violence: Six Sideways Reflections, 96-97.

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