Which approach best describes involvement in discussions about goals of care in pediatric terminal scenarios?

• A. The physician alone
• B. The family alone
• C. Interdisciplinary team including the nurse, physician, social worker, and other professionals
• D. The patient alone

Answer: (C)

In pediatrics, decisions about goals of care in terminal scenarios require input from a team rather than a single person. The best approach brings together the nurse, physician, social worker, and other professionals to combine medical information with psychosocial, developmental, ethical, and spiritual perspectives. The physician can share prognosis and treatment options; the nurse supports family understanding, care coordination, and symptom management; a social worker addresses emotional, financial, and practical needs and helps navigate resources and support networks; other specialists, such as child life staff, ethics consultants, and chaplains, contribute developmentally appropriate communication, cultural considerations, and moral guidance. This collaborative approach helps ensure that goals of care reflect the child’s best interests and the family’s values, supports shared decision making, and provides consistent, holistic support across care settings. Relying on one person—whether a clinician or a family member alone—misses essential medical information or support systems, and the patient alone cannot encompass the full range of medical, emotional, and ethical factors involved.