The seriously ill or dying child, his/her parents, and siblings all face daunting challenges. The services of a multidisciplinary team are required for optimal care. Experts in the fields of child psychology, psychiatry, and/or pediatric palliative care should be included in this team. Different aspects of the care take into consideration the role of the child in the family, the impact of the diagnosis on the child, loss of control and the threat of these losses. These have to be addressed to ensure an optimal psychological outcome for all concerned, irrespective of the eventual survival or demise of the sick child.