To the Editor.

With rapid advances in technology, neonatologists are increasingly faced with extremely complex discussions regarding critical illness, prolongation of life, and withdrawal of life support in neonates. Such discussions/decisions are often complicated by social and cultural influences. Working overseas for nearly a decade, I have consistently observed a peculiar response from the nursing staff after parents of critically ill neonates have had a talk with the neonatologist. If the parents had tears flooding their eyes, “the bad news was not conveyed appropriately.” If the parents did not cry or did not look shattered, “they were not explained to or did not understand the gravity of their baby's illness.” In either case, “the parents needed more expert counseling or needed to be explained things more clearly.”

I remember the teaching of my wise, old professor of pediatrics in India: “If the night is dark, even a single, lonely star...

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