This paper explores the challenges of resolving conflicting feelings around talking with a child about their terminal prognosis. When children are left out of such conversations it is usually done with good intent, with a parent wishing to protect their child from anxiety or loss of hope. There is however growing evidence that sensitive, timely, age appropriate information from those with whom children have a good relationship is helpful both for the child and their family. There is no evidence that involving children in sensitive and timely discussions creates significant problems, rather that withholding information may lead to confusion, frustration, distress and anger. The authors discuss ways in which families can be supported to have these significant conversations with their children.
- General Paediatrics
- Palliative Care
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Contributors This paper arose out of a series of joint discussions over a number of months in which all five authors took part. The discussions were drafted into a working paper by three members of the group, JA, KS and BW and then circulated round all members, leading to modification and further significant development of the paper.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.
Author note Case examples are based on many years of clinical experience and have been modified to protect anonymity.