References to “good” deaths appear less commonly in discussions of children who die than in recollections of the deaths of elderly family members or friends. This undoubtedly reflects, in part, the different cultural perception of death at a young age that has come with the last century’s sharp reductions in child mortality in this country. Nonetheless, the committee believes that, in general, an earlier IOM committee’s characterizations of “good” and “bad” deaths apply when death comes to a child (IOM, 1997, p. 24):

As noted by the earlier committee, notions of a good death may reflect values of a dominant culture that some may not share. Thus, it proposed that “a humane care system is one that people can trust to serve them well as they die, even if their needs and beliefs call for departures from routine practices or idealized expectations of caregivers” (IOM, 1997, p. 24). This kind of trustworthiness—and the competence, sensitivity, and flexibility it demands—is integral to good palliative, end-of-life, and bereavement care for both children and adults.