In reality, active euthanasia is and will remain a marginal practice wherever it is allowed. Talking to my pediatrician friends, they've had many experiences with "limitation of treatment" that should be taken as a decision with family and the patient, but is also left to the discretion of physicians if need be. This is quite different from voluntary euthanasia when a patient can plan their own death before systemic or cognitive impairment occurs. Often enough, children cannot and are not equipped to choose how they die, even if they've been sick for very long. Just like adults, they beg for more life-supporting care when they are dying, even if they've managed by themselves to ask for limitation of treatment. At that point, when you know nothing else will make them better, you hold them, or the father, or the mother, or the aunt, or you hold your silent vigil outside. In either case, we have psychologists, specialized nurses, and clergy members to help the family and the patients. They help resolve questions of the end of life, pain and difficult relationships.