Parents susceptible to suicide after child’s death

Parents of a sick child who dies at home are at increased risk of committing suicide, according to a report in the British Medical Journal. Access to the child’s potent pain medication after the death may provide an easy avenue for self-harm.

Dr. Dawn E. Davies, from the University of Alberta in Edmonton, Canada, describes two cases that illustrate the potential risks for parents.

The first case was an infant born with a tumor of the face who was treated at home with morphine to control pain and with a sedative for symptoms of respiratory distress. He died the day before his first birthday.

Following his death, the mother refused for two days to have his body released to a funeral home or to return leftover drugs to the pharmacy, but she denied any plans of suicide. The doctors and nurses involved in the case decided to wait until the next day to intervene again with the parents. However, the next morning, the mother was found unconscious and she died. Toxicology tests showed high concentrations of opioids and benzodiazepines.

The second case involved an 8-year-old girl receiving palliative care for advanced kidney cancer that had spread to bone, causing chronic pain for which she was treated with methadone.

After the girl died, the parents stopped answering phone calls. Several days later, the mother was found unconscious after taking the methadone. She survived after treatment in a hospital ICU.

Davies notes that there are no laws or policies regarding the handling of remaining opioid drugs after a patient’s death in the home. Occasionally, parents use the residual drugs for self-harm, despite denial of suicidal intentions.

In a related editorial, Dr. Beverley Raphael, from the University of Western Sydney in Parramatta, Australia, comments that “looking after the caregiver, both before, during, and in the aftermath of the death is an integral part of comprehensive care” for parents whose children suffered a prolonged illness.

She suggests that pediatric oncology units provide bereavement support for families, and that parents be put in contact with support groups.

SOURCE: British Medical Journal, March 18, 2006.

Print Version
Tell-a-Friend