In comparison to palliative care for adults where it does not prolong/shorten duration of life, in paediatric palliative care prolonging life is one of the focus.

In adult palliative care, the decision of the patient is the most important and the patient themselves decide what is the best. However in paediatrics, the child’s view may be different to that of the parent’s and so it may be difficult to know whose wishes to follow. However, age is not a determining factor of the mental capacity of the child and therefore the child should be involved in any decisions regarding treatment.

The death of a child may impact the family more severely than the death of an adult. So there needs to be more support for the family as well as providing it for a longer duration.

 The dose required in children need to be worked out on per kg basis as well as considering the use of paediatric formulation i.e. if unable to swallow tablets.

The dose for opioids may seem very high because children (except ages 3-6months) can metabolise the drugs more rapidly than adults.

As school forms an important aspect of children's life, it is important to inform the child's school of illnesses so that support and arrangements can be made for the child.