TABLE 3.

Arguments for Disclosure of Terminal Diagnosis to Children (1960s–1980s)

Children already know they are ill or dying	“The fatally ill child of 6 to 10 years appears to be aware of the seriousness of his illness, even though he may not yet be capable of talking about his awareness in adult terms.”35
Great effort is required to maintain pretense; the façade usually falls apart	“[C]hildren inevitably sense what is happening to them or in their family, even when a deliberate attempt is made to shield them from tragic, frightening or complicated affairs.”24
Children’s silence may result from lack of secure, open communication environment	“Is the child who does not verbalize concern really unconcerned, or only afraid to speak?”27
Honest and safe communication environment offers support to dying children	“In order to help a child cope with the problems of serious illness, it is necessary to develop an environment in which he feels perfectly safe to ask any question, and completely confident of receiving an honest answer.”39