Children have not been severely affected by SARS‐CoV‐2‐related illness but are vulnerable to the economic and social deprivation arising from the pandemic.1 This document describes unique risks and burdens for children and their care givers during the COVID‐19 pandemic.

The principles for the allocation of health‐care resources apply to the whole population; however, there are particular paediatric considerations. The experience internationally is that paediatric intensive care resources are being utilised to support adult services during the emergency. Ethical tensions also arise from decisions about usual service restriction as a strategy for controlling the pandemic.

This guidance provides a framework for health services and authorities to ensure paediatric concerns are considered during the development of COVID‐19 related guidelines and decision‐support tools, when resources may be constrained by the emergency response. It was developed by a working group of paediatric clinical ethicists, and intensive care and other specialty clinicians. This document is an extension to the other general documents available.2-4 It is intended to be read by clinicians and executive of paediatric and general hospitals, and by health‐related government departments.