Improving children’s palliative care requires a shared vision that connects healthcare, research, education, public institutions and civil society. The Rome Charter 2026, launched in Italy on 28 May 2026, offers one example of how this vision can become a practical commitment, bringing together professionals and institutions around ten principles designed to turn values into action.
The Charter emerged during the conference Paediatric Palliative Care: Challenging Situations and Difficult Choices, organised in Rome by Fondazione La Miglior Vita Possibile with the endorsement of the Italian National Bioethics Committee and the support of leading scientific and professional organisations.
Although rooted in the Italian experience, the Charter addresses challenges that professionals encounter across the world. The need has never been greater. According to international estimates, more than 21 million children worldwide could benefit from palliative care each year, while only a small proportion receive specialised services. In many countries, access remains limited by shortages of trained professionals, fragmented care pathways, inadequate policies and unequal availability of essential medicines. Even where services exist, they often reach children too late or only during the final stages of life. In Italy, around 30,000 children and adolescents require these services, while approximately 11,000 have highly complex needs requiring specialist multidisciplinary teams. Yet only about one quarter currently receive the care they need.
The Rome Charter responds to these challenges by affirming a simple but powerful principle: no child should suffer unnecessarily. Pain relief is not simply a clinical goal but a fundamental human right. Every child living with an incurable but treatable condition has the right to timely, appropriate and personalised paediatric palliative care, regardless of where they live or their family’s social circumstances. Access to care should never depend on geography or inequality.
Another key principle concerns the appropriateness of care. In paediatric palliative care, clinical decisions rarely follow a simple algorithm. Professionals must continually balance the potential benefits and burdens of treatments while keeping the child’s best interests at the centre of every decision. The Charter encourages a culture of proportionality, where interventions aim not merely to prolong life, but to maximise dignity and quality of life according to each child’s individual needs.
The document also reminds us that children are not simply smaller adults. Their physical, emotional, psychological, social and spiritual needs require dedicated expertise, child-specific clinical pathways and research designed specifically for paediatric patients.
Families remain at the centre of this vision. Caring for a child with a life-limiting condition affects every aspect of family life. Psychological, social and practical support should therefore form part of routine care. Whenever possible, children should receive care at home, supported by integrated community services that allow them to remain in familiar surroundings while maintaining access to specialist expertise.
Giuseppe Zaccaria, President of Fondazione La Miglior Vita Possibile, signs the Rome Charter 2026
The Charter also recognises children as active participants in their own care. Whenever age and clinical circumstances allow, professionals should provide honest, age-appropriate information, listen carefully to children’s wishes and involve them in decisions about treatment and care. Respectful communication strengthens trust and helps families navigate difficult choices together.
One of the Charter’s most forward-looking principles concerns continuity of care. Medical advances now allow increasing numbers of children with complex and life-limiting conditions to survive into adulthood. Fragmented care from paediatric to adult services can interrupt established relationships, compromise continuity and increase uncertainty for young adults and their families. The Charter calls for coordinated transitional care pathways that preserve expertise, maintain therapeutic relationships and support patients throughout this critical stage of life.
As stated before, although developed in Italy, the Rome Charter 2026 speaks to an international audience. In fact, many countries face similar challenges: workforce shortages, unequal service provision, limited awareness of paediatric palliative care and fragmented transition pathways. So, the document provides a framework that other organisations can adapt to their own healthcare systems while keeping children’s rights and dignity at the centre. Its ten principles offer a starting point for dialogue, advocacy and service development, whether in countries building new paediatric palliative care programmes or in those seeking to strengthen established networks.
This emphasis on partnership reflects an increasingly global understanding of paediatric palliative care. Sustainable progress depends not only on clinical excellence but also on public awareness, political commitment and collaboration across sectors. The Rome Charter 2026 invites governments, universities, scientific societies, healthcare providers, charities and community organisations to build a shared agenda. The document calls for stronger research programmes, systematic education and training, earlier care planning and regional networks that guarantee equitable access across countries.
Ultimately, the Rome Charter reminds us that improving children’s palliative care is a collective responsibility. Achieving that goal requires shared leadership, shared learning and a shared commitment to ensuring that no child is left behind.
Because every child deserves the best possible life.
Read the full Declaration here.
Author: Alessia Turlon, Institutional Relations and Fundraising Manager, La Miglior Vita Possibile Foundation. Italy. Contact: info@lamigliorvitapossibile.it
Leave a Reply