ABSTRACT
Due to the nature of the cases admitted, a majority of inpatient childhood deaths occur on the pediatric Intensive Care Units (PICU). A recent examination of the PICAnet database showed that only a very small proportion of children were deemed to be transferred to palliative care as determined by the completion of the discharge form. For most families, the hard work of coming to a decision about withdrawal and the timing of withdrawal will have occurred on the intensive care unit. Staff on a PICU may have little time to get to know and support the families of critically ill children. Being able to understand and support the family will help develop trust between strangers and allow open discussions about the best interests of children. However, providing high quality End-of-Life care should be the principal function of a hospice and being confident that this can be achieved in all circumstances can be very rewarding.
