The pediatrician should be involved in any major changes in the goals of care, specifically a switch to end-of-life and palliative care, and of course should be immediately notified of a patient's death. “It's at that point that I think the pediatrician should be reinvolved in a significant way,” he said. This provides further emotional support for the family, reinforces the therapeutic relationship, and assists in psychosocial screening. The pediatrician's involvement at this stage also is often particularly helpful for surviving siblings.