We must give children a voice in advance care planning

Advance care planning (ACP) has become a key component of end of life care, but it involves far more than just conversations about whether or not to resuscitate. The wishes and preferences of the person concerned must be identified before they are too unwell to be involved in decision making. However, insufficient research and guidance exist on involving children and adolescents in advance care planning.

Retrospective interviews with the parents of children who had an advance care plan found the process helpful in assuring that the best care was obtained for their child, and in avoiding unnecessary suffering and preserving quality of life.1 Perhaps unsurprisingly, these plans focused exclusively on medical interventions, covering decisions around resuscitation, artificial feeding, intubation and ventilation, antibiotic use, and admission to hospital. Parents reported “having peace of mind” and retaining a sense of control once they had signed the plan, but it is unclear whether their children experienced …