The literature reviewed in this chapter as well as illustrative vignettes suggest several directions for improving the effectiveness and consistency of pediatric palliative and end-of-life care. These directions include better understanding of the dimensions of pediatric palliative and end-of-life care and better understanding and application of existing knowledge and resources. Other directions include changes in the organization of care that may increase the effectiveness and reliability of such care, better training of health professionals in the principles and techniques of palliative and end-of-life care (including accurate but sensitive communication), and more research on almost every dimension of such care and the medical and other criteria for identifying children and families who might benefit from it. The next several chapters expand on these topics and also review the financing, legal, and ethical context of care for children with fatal or potentially fatal medical conditions.



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