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A Bioethical and Relational Perspective
The word “communicate” comes from the Latin communicare, which means “to share,” “to make known,” or “to bring together.” This verb derives from the Latin adjective communis, which is composed of cum, meaning “with, together,” and munus, meaning “gift, task, duty.”
The etymology of this word prompts us to reflect on how communication is more than just a space for interaction or a duty; it is a gift. Just as we strive to pay attention to the details when offering a gift, so too must we show care for others when choosing our words, because the power of words is great—they can give hope and transform a person’s life for the better, or they can linger and affect the person for the worse.
Words have a powerful impact in difficult times, as people are often more vulnerable in such moments.
For this reason, in the medical and healthcare fields, and especially in palliative care, welcoming, attentive, and respectful communication helps initiate the therapeutic process, demonstrating care through relationships.
If we read the World Health Organization’s definition of pediatric palliative care, “the active total care of the child’s body, mind, and spirit, and also involves giving support to the family,” we understand how fundamental relational and communicative aspects are. They are implemented when the patient’s condition is characterized by an irreversible course and a poor prognosis, and when the patient no longer responds to specific treatments. The goal of care is no longer to fight the disease itself, but to manage its symptoms, making them tolerable.
Palliative care refers to a broader and more complex concept of patient care, aimed at ensuring the well-being of the whole person.
Supporting relationships are integral to holistic care, with the goal of making patients feel valued and promoting dignity and hope.
As a spiritual being, the human creature is defined through interpersonal relations. The more authentically he or she lives these relations, the more his or her own personal identity matures. It is not by isolation that man establishes his worth, but by placing himself in relation with others and with God. Hence these relations take on fundamental importance.
Communication as a Tool for Care in the Pediatric Field
In pediatric and perinatal palliative care, communication mainly involves physicians, hospital staff, and the child’s family. It includes both verbal and nonverbal elements—such as body language, silence, and listening—as well as maintaining appropriate physical distance and gestures of compassion (See Farro Giovanni. La comunicazione in medicina palliativa. La rivista italiana di cure palliative 2024).
Communication among medical staff must also be focused on the family and the patient, always recognizing and respecting the child—whether born or unborn—in their dignity and identity as a person. Indeed, every human being has their own personal history, whether long or short, and a concrete identity that must be respected and valued at every stage of the care relationship.
Certain skills must be acquired; they cannot be improvised. Healthcare staff should undergo training in communication techniques to effectively manage sensitive situations. Staff need specialized guidance on how to interact with children, adapting their approach to the child’s age and stage of development, listening to their needs, and involving them whenever possible. Families should be actively involved through open dialogue and emotional support; this approach would foster trust and create a comfortable and welcoming care environment.
How Communication and Nonverbal Attitudes Shape Patients’ Spiritual Openness
The quality of communication, as well as the attitude of healthcare staff toward the patient, including nonverbal communication, has an impact on the patient’s state of mind. A perspective of faith offers a critical source of support; it offers spiritual comfort and provides a framework for understanding life’s painful events.
An interesting study was conducted in this area in Denmark, a highly secularized society, where patients’ spiritual needs are often overlooked. This study demonstrates that the patient’s perception and the patient’s bodily experience of the healthcare professional are crucial to whether the patient opens up to the healthcare professional about thoughts and needs of a spiritual nature and initiates a conversation about this.
Nonverbal Communication in Pediatric Palliative Care
Effective communication in healthcare relies largely on nonverbal interactions and mutual understanding between patient and provider. A patient’s comfort and sense of connection encourage them to share their spiritual needs. Nonverbal cues—such as the caregiver’s presence, behavior, and touch—are essential for fostering meaningful verbal conversations about spirituality.
Prof. Carlo Bellieni, a pediatrician and neonatologist, explains that “through the way the child feels looked at…they learn to look at themselves. Not because someone tells them to, but simply by osmosis. They absorb it” (Carlo Bellieni, I primi 1000 giorni d’oro. Puericultura per i genitori e per chi cura i bambini. The first 1,000 golden days. Childcare for parents and caregivers, Àncora).
Prenatal Communication: Influence, Perception, and the Relationship between Mother and Child
In the case of an unborn baby, the dynamics are different. The baby is protected inside the mother’s body, but the walls of the uterus do not provide a completely isolated environment. Prof. Bellieni describes them as a filter through which, by the middle of pregnancy, sensory perceptions begin to prepare “the fetus for what awaits it outside the womb.” So we can say that communication with the unborn child is filtered through the mother.
It is important to consider that another person, who has not yet been born, is present, and that what happens outside the womb will affect her. Studies have shown that, for example, if a mother leads a very active life, the baby will need to be rocked more vigorously to fall asleep after birth, precisely to recreate the “atmosphere” she experienced inside her mother’s body.
Compassion and warmth are the two key elements of pediatric and perinatal palliative care. The absence of these feelings and attitudes can lead to trauma that is difficult to overcome.
In the words of Benedict XVI, it can be said that “One of the deepest forms of poverty a person can experience is isolation. If we look closely at other kinds of poverty, including material forms, we see that they are born from isolation, from not being loved or from difficulties in being able to love.”
