Parents are the default decision-makers for their infants and children. Their decisions should be based on the best interests of their children. Differing interpretations of children’s best interests may be a source of conflict. Providers’ biased evaluations of patients’ quality of life may undermine medicine’s trustworthiness. As children mature, they should participate in medical decision-making to the extent that is developmentally appropriate. In this month’s Ethics Rounds, physicians, a philosopher, and a lawyer consider parents’ demand, supported by the hospital’s legal department, that their 17-year-old son be excluded from a potentially life-and-death medical decision.

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