It’s something right out of Grey’s Anatomy. Kaylee is two months old and was on life support. After much heartrending consideration, her parents decided to take her off life support and committed to donate her organs to other needy babies.

On the other side of the coin is one-month-old Lillian, waiting for a matching heart for transplantation in order to survive.

To the surprise of everybody, including her doctors, Kaylee could breathe on her own without life support equipment. Because of this, Kaylee is not eligible for organ donation. Lillian has been put back on the organ waiting list. Both babies are fighting for their lives.

It’s an emotional roller coaster for the parents of both Kaylee and Lillian. Kaylee’s parents who were resigned to losing their little daughter are now caught between hope and fear because Kaylee’s condition can still go either way. Lillian’s parents are also in the same situation of hope and uncertainty. Will their baby get a new heart in exchange of Kaylee’s life?

Last year, several articles the August issue of the New England Journal of Medicine looked at pediatric heart transplants. According to one study, about 400 heart transplants are performed in American children every year and about of 100 these are performed in children younger than 1 year. In addition, up to 50 babies who are on heart transplant waiting list do not survive the waiting time.

However, heart donation and transplantation is a very sensitive topic because of the clinical and ethical question involved. Death and transplantation should occur almost simultaneously so that the heart function is not completely lost and can be restarted to beat in the recipient’s body. Donation, however, is only possible when the donor has been declared clinically dead. Unfortunately, despite advances in medical science, the definition of “death” is not clear cut. Should it be based on brain death or cardiac death criteria? If heart function can be restored (albeit in another person’s body) after the death has been declared, was there a chance that it could have been restarted in the donor’s body to revive him/her? How long should we keep a loved one on life support?

I advocate organ donation and I have an organ donor card. I also have 2 young children and I only hope I wouldn’t be in the position to choose between giving up on my child to save another child’s life. Or have my child in an organ waiting list for that matter. But life is not always fair and these scenarios can happen to anyone.

To Kaylee’s and Lillian’s parents, I wish you all the strength and courage in your trying times.

On Wednesday, we heard tragic news of the death of actress Natasha Richardson from a skiing accident (featured on right).

And across the pond, celebrity watching has taken a ghoulish turn with the obsessive coverage of cancer-stricken reality TV star Jade Goody’s imminent death. After being diagnosed with terminal cancer and given just weeks to live in February, she sold the rights to her wedding to a celebrity magazine and appeared on countless TV shows and in newspapers to discuss her illness, her marriage, and numerous products – perfume, books, fitness DVDs – she’s lent her name to.

The connection? Both women are mothers, Natasha Richardson has two teenage sons with her husband Liam Neeson, and Jade Goody also has two sons, aged four and five.

I never gave it much thought before I had my son, but now I’m a mom it occasionally worries me. What would happen to my son if I died? I don’t have a will, I’m separated from his father, I live in a different country to my family, I don’t have any life insurance. Who would look after him and how would they afford it? I’m more worried more about who he would end up living with than the money, but I also want him to have at least as much financial security as I could provide for him.

Jade Goody’s has stated that her motivation for dying in the public eye is to make as much money for her son’s futures before her death. Loosing their mother is as hard for celebrity children as it is for non-celebrity kids and I would imagine that it won’t be much comfort for Jade or Natasha’s boys that their financial futures are taken care of.  But I guess that their mothers would prefer that their children won’t have the extra stress of worrying about money.

Neither woman could have expected that they would leave their children motherless. Jade was diagnosed with cervical cancer at the very young age of 26, and Natasha was probably enjoying a fun day on the slopes. We have no control over accidents and illnesses but we can have some control over what comes next if the worst happens. All parents should have a will, and moms in circumstances like mine with broken families or other complicated situations need one most of all. A will is important because it can state your wishes for who should look after your child or children, and allocate money for doing so.

So where do you start? Wills can be complex depending on your circumstances, but here’s an overview of the process and a brief guide from CNN for parents to make a will.

I remember finding out on Christmas Day that we were expecting our newest arrival.  I remember calculating due dates and realizing that this child was due to arrive the day after my grandmother’s birthday in August.

We just got word that my grandmother is dying.  She has been ill for a while, but things have taken a dramatic turn for the worse this week.  Tomorrow, our family will make the 800 mile drive north to say goodbye to her.

I last saw my grandmother almost two years ago, when my son was only a few months old.    My grandmother was so proud of her great-grandchildren!  She sat and read them stories and sang to them and we took videos and pictures to document the whole visit.  My sister had also arrived from out of town with her children and all of the cousins had a wonderful time together.

My grandmother does not yet know that we are expecting a child.  I knew that she’d worry about me, and about the baby as I am of “advanced maternal age“.  I thought it best to not worry her.  Will I tell her about her new great-grandchild? Probably not.  This weekend is not about that.

I know this weekend will be hard, but I’ll concentrate on the good times and think of those things.  Death, sadly, is part of life.  I can’t change that.  But I can choose to focus on the positives instead of dwelling on my sadness.

First of all, this post can make you feel bad, even depressed. But it’s an important issue that some parents and parents-to-be might have to face. So if you are not up to some sad posts today, please don’t read this.

It’s every mother’s, every parent’s nightmare – a baby or a child who are so ill or so extremely premature that he or she has to be placed on life-support system. The decision whether to pull the plug is one of, if not the hardest to make.

A study by researchers at the Johns Hopkins Children’s Center explores some of the communication problems between healthcare providers and parents of children in making life-and-death decisions as the one described above.

26 mothers who went through the pain of losing a baby granted in-depth interviews 3 years after and revealed the following:

Many mothers felt that doctor-parents discussions were prone to misunderstandings.

• They felt that what they were told by doctors and what is recorded in the medical chart of the patient are often at odds. One mom, for example, reported being told that “nothing could be done” but the chart discussed several options.
• Very few could recall discussions about all the options which would range from “aggressive resuscitation to palliative care through the end of life.”
• If the options were ever discussed, they were not clearly explained. Many found the “doctors’ speak” vague and confusing.
• Most moms did not trust doctors who are detached and lacked empathy.

In a previous post, I reviewed a report about obstetricians getting traumatized during difficult and sometimes fatal birth outcomes. It seems that aside from not being able to handle the emotional burden of a patient’s death, some doctors also cannot seem to empathize with family members. The authors think that many doctors

• feel uncomfortable during such emotionally intense moments.
• have difficulty in delivering bad news clearly but compassionately.
• feel that showing too much empathy can give the parents ” a false sense of hope.”

There is clearly a gap between what the parents of the patients need and what the doctors are delivering. This gap can be bridged by proper training of the doctors as well as guidelines from the doctors’ association such as the American Academy of Pediatrics, the authors conclude.

My daughter learned to speak at a very early age. She has always had a huge vocabulary for her age, and although I think it helped a lot when it came to discipline because she could convey her wants and needs and she could also understand what I was asking of her, she also came up with some really tough questions that I was often taken aback by.

When she was nearly two she asked me what was in the cemetery we drove by, who Jesus is, and where babies come from…all in one car drive coming home from the store. No kidding. I tried my best to answer all her questions without acting as though I was perplexed by what the correct age-appropriate answers for her would be, although I was indeed a little confused as to how to answer the questions without taking the conversation to a different place. I told her the cemetery had gravestones, Jesus is the same guy we talk about in church, and babies come from mommies. She seemed fine with these responses, and I gave a big sigh of relief.

I don’t know why it’s so hard to talk about death, spirituality, and sex with my daughter…I think it has something to do with the fact that I’m not quite convinced that she’s ready to grasp these concepts fully and I don’t want to say something wrong and mess up her way of thinking about these sensitive things.

One thing is for sure, though; the questions are only going to get harder as time goes on!