How Can We Say to Neonatal Intensive Care Unit Parents Amid Crisis, “You Are Not Alone”?

Perhaps the greatest challenge for clinicians in the neonatal intensive care unit (NICU) is decision-making for the critically ill, or dying, newborn with his/her family. Although we strive to engage in shared decision-making, issues of human values, prognostic uncertainty, and plurality may impede good communication. Our sympathy may be at work in our trying to understand the complexities of circumstances that a particular family operates in. Empathy, however, requires that we be able to act as if we were the other person. More than simply seeing or understanding, it requires our knowing—in essence, putting ourselves in their position and (vicariously) experiencing their dilemma. Short of having experienced similar circumstances ourselves, many of us might feel that simply saying the words, “You are not alone” …

Reprint requests to (B.S.C.) Department of Pediatrics, Division of Neonatology, A-0126, Medical Center North, Vanderbilt University Medical Center, Nashville, TN 37232-2370. E-mail: brian.carter{at}mcmail.vanderbilt.edu