The editors would like to offer their thanks to the authors of the chapters in this book for their thoughtful contributions. Inheritors of a long tradition of silent service, they have been willing to add their voices to an ongoing dialogue between providers of and observers of medical care in the late twentieth and early twenty-first centuries, for which we are grateful.

The children and the families for whom we have had the privilege of caring during their various illnesses are honored as well in these pages, though the details of the cases have been changed by the authors to prevent any identification of particular patients.

Although it is the physician's voice that is most often heard in this volume, we gratefully acknowledge that the work of the hospital involves many helping professions, including nurses, therapists, chaplains, social workers, and clinical ethicists.

The areas of pediatric medicine and of medical ethics have been impoverished by the loss of William A. Silverman, who died as this volume was in preparation.

The book has been greatly helped by the thoughtful comments of anonymous reviewers and the scrupulous and authoritative editorial work of Hugh Brazier, and is dedicated to our families, who support our work, and to the children.