This chapter explores three issues providing challenges in the area of truth telling in pediatrics. First, whether it is the duty of pediatric practitioners, regardless of their professional discipline, to disclose information to patients who are children or adolescents, and to the parents of their patients, is not absolute; in pediatrics there is also a duty to respect parents' role in shaping the context of care and information provision. Second, challenges associated with truth telling often arise because practitioners and family members have different cultural backgrounds, and one's cultural background affects the importance one places on truth telling in the health care context. Third, parents' desire to withhold information about their child's impending death from that child is especially challenging for the child's health care providers. When children have a life-threatening illness or are dying, their vulnerability is great and the urge to protect them may be overwhelming.