Dr.  Ronish Gupta is a Pediatric Intensivist and the medical director of the Pediatric Intensive Care Unit at McMaster Children’s Hospital. He a special interest in interprofessional and simulation education of health professionals.Dr. Dave Lysecki is the Division Head of Pediatric Palliative Medicine and the Medical Director of the Quality of Life & Advanced Care program at McMaster Children's Hospital. His clinical role frequently finds him trying to help families anticipate and navigate through rough waters. Dr. Eiman Al-Hashemi is a subspecialty fellow in pediatric critical care medicine at McMaster University. She previously completed pediatrics residency at McMaster University and has a special interest in palliative care. In this session of Grand Rounds, they use case examples to review the theory and process of creating goals of care for children. Understanding that patients and families hold their own values,can change and influence the type of care planning for the child. By the end of the sessions, participants will have an increased understanding of how medical information and patient/family values interact and form the basis for goals of care planning.