Terminal lucidity in children: A contemporary case collection.

The unanticipated occurrence of unusually enhanced mental clarity just before death has been reported across time and cultures and has come to be known by the term “terminal lucidity.” Cases that appear to be characteristic of terminal lucidity in children have been sporadically documented in historical and more recent literature, yet no studies have systematically examined the characteristics of terminal lucidity in children. Employing a 42-item online survey, this study collected case reports of terminal lucidity in 11 children aged 16 years and under. We recorded disease progression and treatment regime, behavioral and emotional changes prior to and during terminal lucidity, the proximity of terminal lucidity to death, and the terminal lucidity duration. Results revealed that terminal lucidity tended to occur within the final hours to minutes before death of the child and typically manifested as notable changes in mental abilities, as well as marked behavioral and emotional changes. Terminal lucidity did not seem to be precluded by any changes in medical regime and seemed to happen in spite many children being in semi- or comatose states just prior to the lucidity episode. Such results suggest a surge of mental clarity in terminally ill children does occur in spite of medical expectations that it should not, which may have implications for enhancing end-of-life care in terminally ill children, as well as for developing understandings about the nature of consciousness at the end-of-life.