This chapter will discuss the key physiological changes communication and symptom management considerations required to provide care of the dying patient in humanitarian crisis situations while providing optimal care for dying patients in these situations may be challenging a clear understanding of key components of good care can guide clinicians to prioritize their efforts. The decision to forgo life sustaining medical treatment does not necessarily imply an intent or choice to hasten the death of a child 25 although a childs life may be shortened by forgoing burdensome interventions or providing adequate sedation in the face of otherwise unrelieved symptoms the goal of palliative care is to optimize the quality of the childs experience rather than hasten . Major improvements in living standards medical knowledge and care nutrition water and sanitation and treatment of disease had transformed outcomes for mothers and children for the first time in millennia most parents would not lose a child child mortality was still fairly common but no longer the norm but 1950 was also a divided world
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