Obstacles to the promotion of dialogue between parents, children and health professionals about death and dying in pediatric oncology

Despite advances in cancer treatments and improved prognosis, the number of deaths from the disease is high in the world. In Brazil, cancer is the second leading cause of death among children and adolescents, forcing family members, patients and professionals to deal with the issues of human finitude. The multidisciplinary team considers the discussions at the end of life as a difficult task to be performed on pediatric patients. The family is essential to overcome the communication barriers, acting as liaison between the multidisciplinary team and the patient. Children should be invited to participate in the decisionmaking process and their wishes should be honored at the end of life. Professionals should to be able to meet the physical, psychosocial, spiritual, social and cultural rights of patients and families. Discussions at the end of life with pediatric patients are key to promoting a "good death", however there are few studies that address this issue.