Advanced care planning in children with life-limiting conditions - the Wishes Document

The number of children with severe life-limiting conditions is increasing, and at present most of these patients die in hospital, often on PICU. We advocate that end-of-life planning should take place with children and their families at an opportune time following diagnosis, and not just prior to death. This approach should not eliminate hope but rather allow a family to refocus their aspirations in a realistic fashion. All paediatricians should be aware of national policy in respect to palliative care, and be mindful of their responsibility towards ensuring that every child with a life-limiting illness has an end-of-life plan. The Wishes Document has been adopted by the Association for Children's Palliative Care and is offered as a guide to clinical teams who may hold such discussions with children and their families.