Parents whose children died in the PICU value personal connectedness to doctors and nurses when coping with existential distress. Medical and nursing training programs should raise awareness of parents' need for contact in all interactions but especially in times of crisis and apprehension.

End-of-life treatment in the PICU presents both a barrier and an opportunity for parents to stay physically connected to their child. Parents' experiences suggest that aspects of physicality in medical settings deserve more attention. Better understanding of the significance of bodily aspects-other than pain and symptom management-improves end-of-life support and should be part of the humane approach to families.

Spiritual care is recognized as a relevant dimension of health care. In the context of pediatric palliative end-of-life care, spirituality entails more than adhering to a spiritual worldview or religion. Interviews with parents whose critically ill child died in the pediatric intensive care unit revealed features of a spirituality that is fragmentary and full of contradictions. This type of spirituality, which we refer to as fragile, speaks of parents' connectedness with the deceased child and the hope of some kind of reuniting after one's own death. Acknowledging that fragments of spirituality can be part of parents' experiences in their child's end-of-life stage can be a meaningful contribution to compassionate care.

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Despite medical advantages, many parents are still confronted with child loss due to preterm birth, trauma or life-threatening illnesses.Losing a child is considered the ultimate loss that any parent can experience. Bereaved parents are at risk of developing adverse psychological and physical consequences, 1-3 and are prone for prolonged grief disorder. 4,5 Grief is a natural response to the loss of someone, or something, meaningful and encompasses a range of emotions including separation distress, anxiety and dysphoria. 6 Bereavement care is an integral part of paediatric palliative care, yet it is developed mostly in order to