Making decisions about medical treatment for your baby or child can be stressful and difficult. You’re probably already upset that your child is sick or in pain, and you may be faced with having to make decisions quickly.

To ensure that children benefit from the best decisions about their health and treatment, decisions should be made jointly by members of the health care team, their parents, and sometimes the children themselves.

Some examples of decisions you may have to make are as follows:

• If there is more than one treatment that may help my child, which one should I choose?

• Should my child have treatment now, or may we wait for a while?

• The treatment my child’s doctor recommends has harmful side effects, but may also improve her condition. How do I decide what is best for her?

Babies and very young children

Parents (or guardians) are usually the main decision makers for their young children.

If you have to make a decision, here are some things to think about:

• Consider all information that you have from your child’s health care providers.

• Ask for more information or help from an interpreter if you need it.

• If you don’t understand something, ask questions.

• Consider all the choices available to you and your child. Sometimes, deciding not to have treatment will be one of the choices as well.

• Think about how these choices are likely to affect the life, health and well-being of your child.

• Consider your personal, cultural, moral, spiritual and religious values and beliefs and how these may affect your decisions.

• Consider your needs and your family’s needs, but make sure that the needs of your ill child come first.

Informed consent

After you talk to your child’s health care providers about all the issues and you’ve made a decision, you may be asked to give informed consent and, sometimes, to sign a consent form.

Informed consent means you:

• understand your child’s medical condition

• understand your choices

• understand the risks and benefits of the choices

• have had the chance to ask questions

• are making a decision of your own free will

• agree to the treatment

If you still have questions or concerns, discuss them with your health care providers before you sign a consent form.

Older children and teens

As children grow and develop, it is important to share truthful information with them, answer their questions, and include them (if they wish) in making decisions about their health and treatment. This may help them to be less afraid and anxious, and they will be more likely to trust their health care providers.

Eventually, young people themselves will be asked to make decisions and give informed consent for their own treatment. This is their legal right, and their health care providers have the responsibility to make sure this happens.

The legal age of consent is different depending on which province or territory you live in. In some provinces, there is no specific age, but it depends on the young person’s ability to understand and make decisions. Your physician should know or be able to find out for you.

End-of-life decisions

Making decisions for a dying child may be especially difficult for parents, who are suffering from extreme sadness and grief. At this time, health care providers try to make the child comfortable and provide relief from symptoms (like pain and shortness of breath). Sometimes the right decision may be to stop life-support and allow the child to die as peacefully as possible.

When people disagree

Sometimes parents may disagree with each other or with a member of the health care team about what is best for the child. If this happens, you may want to consult others for help. For example, some hospitals have individuals who may be able to assist with decision-making and conflict resolution, such as an ethics consultant or patient representative.

You may also want to bring someone you know to a meeting, such as another family member or a member of your religious community.

Sometimes it may help to get a second medical opinion or to replace a member of the health care team (though this option may not always be available).

For more information:
Treatment decisions regarding infants, children and adolescents, a statement of the Canadian Paediatric Society.

Developed by the CPS Bioethics Committee

Reviewed: February 2008