Medical decision-making has undergone major transformation in the past half century. Before the 1970s, health-care decisions were largely the domain of health-care professionals. Since then, the pendulum has swung, at times overcorrecting, so that patients and families may have been expected to bear the decision-making process alone in a milieu that prioritized autonomy. With the advent of shared decision-making (SDM), the shift has been toward a partnership. SDM offers a path forward, when medical decisions arise, informed by different participants’ perspectives, all of which deserve appropriate consideration. In pediatric medicine, this framework emerges within a more complex web of participants that might include representation from health-care professionals, parents or guardians, and a child. Also, SDM in the pediatric setting must take into consideration that children exist along a developmental spectrum with respect to their ability to share in decisions. These unique pediatric features have helped expand a concept born out...

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