Ethics SeriesCommunication and Cultural Sensitivity for Families and Children With Life-Limiting Diseases An Informed Decision-Making Ethical Case in Community-Based Palliative CareKoch, Amie DNP, FNP-C, RN, ACHPN; Grier, Kimberlee BSN, RN, CHPPN, CHPNAuthor Information Amie Koch, DNP, FNP-C, RN, ACHPN, is an assistant professor, Duke University School of Nursing, and a community hospice and palliative care nurse practitioner at Transitions LifeCare, Durham, North Carolina. Kimberlee Grier, BSN, RN, CHPPN, CHPN, is a hospice and palliative care nurse at Transitions LifeCare, and co-chair of Fostering Families, Durham, North Carolina. Address correspondence to Amie Koch, DNP, FNP-C, RN, ACHPN, Duke University School of Nursing, 307 Trent Dr, Box 3322 Durham, NC 27710 (Amie.Koch@duke.edu). The authors have no conflicts of interest to disclose. Journal of Hospice & Palliative Nursing: August 2020 - Volume 22 - Issue 4 - p 270-275 doi: 10.1097/NJH.0000000000000654 Buy Take the CE Test Metrics Abstract The health care decisions of families of children who have life-limiting genetic diseases are impacted by multiple factors including religious and ethical values, education and knowledge, emotional trauma, availability of support, and accessibility of care. Palliative care nurses must practice the highest standards by delivering nonbiased, nonjudgmental support to patients and families; however, nurses may experience moral distress if their personal values conflict with a family's decisions and needs. This case focuses on a family receiving community-based palliative care for a child with a genetic life-limiting disease. They had a family history of this disease, which had caused the deaths of previous children, and the mother had a current unplanned pregnancy. The care team overcame language barriers and cultural obstacles to establish a trusting relationship with the vulnerable pregnant mother. They were able to support her decision to terminate her pregnancy safely by helping her to navigate a complex health care system. Using 5 crucial pillars to assist health care members with the delivery of nonjudgmental family-centered palliative care is recommended: (1) identification of biases, (2) utilization of a culturally safe approach, (3) effective communication, (4) assessment and support, and (5) knowledge of community resources. Copyright © 2020 by The Hospice and Palliative Nurses Association. All rights reserved.