Prolonged grief as a disease? Ethics of advance bereavement planning and the case for pediatric palliative care

Definition of the problem The eleventh version of the International Classification of Diseases (ICD-11), which became effective in 2022, has raised a number of issues associated with medical ethics. Arguments In this context the paper explores the normative view of grief as a disease. ICD-11 contains the new diagnosis of "prolonged grief disorder" with a definition that fails to aid its clear distinction from the normal course of grief. The article discusses the philosophical and ethical implications of this diagnosis and explores the risks of medicalizing and pathologizing grief which may lead to an undermining of its value. Conclusions and further perspectives The paper's specific focus is the particular case of parental grief. We show that pediatric palliative care counteracts many risk factors for difficult grief reactions and may therefore serve as a valuable instrument for their prevention. We propose in this context the concept of "advance bereavement planning" as a potentially beneficial extension of advance care planning and palliative care in general.