“…Some barriers to adequate EOLd were identified in previous studies irrespective of patient age or disease. Among them, healthcare provider factors (the lack of experience, discomfort with death and dying [12,38], lack of knowledge, uncertain prognosis [12,39], uncertain right time to address the issue [12,40] and reluctance to discussion [12,41] and patient and parent factors (the inability of patients to comprehend, lack of readiness, unrealistic expectations [12,40], family's opposition, [12,38] lack of familial acknowledgement of terminal condition [12,39], patient's willingness to protect other people and the inability to imagine a possible death [12,41]. So, Discussions of advance care planning frequently happen late in illness [37].…”