Pediatric palliative care


• Definition of pediatric palliative care
• Principles of palliative care
• Differences from adults
• Levels of provision
• Identification of the target population in Pediatrics
• Illness trajectories in Pediatrics
• Models of service organization
• Needs of the child & family
• Symptom control
• Individual care plans
• Communication with child & family
• Informed decision making
• Communicating bad news
• Grief and bereavement: phases, tasks and support
• Protection and social benefits for the child with chronic illness & family
• Principles and organization of educational support
• Interdisciplinary collaboration: the role of the doctor in teamwork
• Interinstitutional collaboration (including tertiary – primary care)
• Homecare
• Transitioning to adult services
• Legal issues
• Ethical questions – limiting/withdrawing therapies/interventions; terminal sedation; decision making
• End of life and terminal care
• Role of non-governmental organizations in provision of pediatric palliative care

General characterization





Responsible teacher

Mestre Ana Forjaz Lacerda


Weekly - Available soon

Total - Available soon

Teaching language





• Carter BS, Levetown M, Friebert S. Palliative care for infants, children and adolescents - a practical handbook. 2ª ed. Baltimore, 2011.
• Cuidados paliativos pediátricos – uma reflexão. Que futuro em Portugal? 2013, Fundação Calouste Gulbenkian.
• FACTS. Cuidados paliativos para recém nascidos, crianças e jovens. Fondazione D'Onlus. Roma, 2009.
• IMPaCCT - standards for pediatric palliative care in Europe. Eur J Palliat Care 2007; 14 (3): 109-14.
• Larcher V et al. Making decisions to limit treatment in life-limiting and life-threatening conditions in children: a framework for practice. Arch Dis Child 2015; 100 (suppl 2): s1-s23.
• Levine D et al. Best practices for pediatric palliative cancer care: a primer for clinical providers. J Supp Oncol 2013; 11(3): 114-125.
• WHO. Guidelines on the pharmacological treatment of persisting pain in children with medical illnesses. Geneva, 2012.

Teaching method

In this Unit the following methods will be used:
• lectures;
• tutorials (clinical case discussions);
• clinical attachments (according to the agenda of both lecturers and students – homecare with the UMAD HDE);
• practical classes (communication training).

Evaluation method

The usual methods of evaluation are:
• tests (two, multiple choice);
• case study:
 slide presentation (10 minutes) and discussion;
 poster presentation.
However, in the current context of the COVID-19 pandemic, which may preclude clinical contacts as happened in the school year 2019-2020, there may be the need to change this. In this case evaluation will be done through:  
• written essay answering a question; 
• written care plan following a clinical vignette:
 slide presentation (10 minutes) and discussion;
 written self-reflection.

Subject matter

1. Principles of pediatric palliative care;
2. Palliative care needs in Pediatrics;
3. National and international scenario;
4. Service organization;
5. Care planning;
6. Ethical questions in pediatric palliative care;
7. Communication with the child and family;
8. Health and disease in childhood;
9. Grief;
10. Social support;
11. Role of school and education;
12. Role of play;
13. Interdisciplinary articulation;
14. Interinstitutional articulation;
15. Experience of the Pediatrics Department of the Portuguese Institute of Oncology - Lisbon;
16. Experience of the Hospital de Dona Estefânia, CHULC;
17. Experience of the Neonatal Intensive Care Unit of the Hospital S. Francisco Xavier, CHLO;
18. Experience of the pediatric homecare teams;
19. Homecare;
20. Clinical case discussions.


Programs where the course is taught: