Despite the fact that many children are cured from cancer, this illness remains the leading cause of death among children due to disease. When the likelihood of death is confronted, decisions regarding how best to provide care must be made. Research regarding what factors influence this choice and the effects that different modalities of care may have on the family system are discussed. This discussion and review of the literature will assist the pediatric nurse in guiding the family to an appropriate choice for me care of their child. Pediatric nurses must be aware of the many technical, economic, and theoretical issues which confront a family prior to making this very difficult decision.