Talking with children and families about the possibility or probability of death is one of the most difficult things a doctor must do. It can arouse feelings of sadness, guilt and fear, including the fear of causing further pain to already suffering children and their families.

Like any difficult task, doctors might find themselves delaying these conversations, or avoiding them altogether. For this reason, a suite of resources called the Thinking ahead framework has been produced.

This framework is intended to assist paediatricians and other health professionals approach advance care planning. It offers:

• principles upon which to base practice
• a progressive approach to discussions
• tools to capture key information and decisions that have been made and communicate these to other healthcare providers.

The Thinking ahead discussion guide provides case examples, as well as a useful phrases to help staff frame and phrase the discussion.