There are many barriers that can prevent physicians from talking with pediatric patients and families about end-of-life care, including lack of communication skills and training, uncertainty about a prognosis, and lack of parental readiness, Dr. Emily Riegel writes in Pallimed. She said these difficult discussions must occur, however, and for those clinicians who cannot do it, there are "those of us passionate about pediatric palliative care here to guide and support our professional colleagues just as much as we are here for the patients and the families."

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