Telling the Child: Ethics of the Involvement of Minors in Health Care Decision-Making and in Considering Parental Requests to Withhold Information from Their Child

Abstract

Truth-telling is a core value in medical ethics, and its importance has only grown in recent decades with the increased focus on patient-centered care. How and whether to inform children about aspects of their health care (and how/whether to include them in health care decision-making), however, is even more complex. In this chapter, using an example case, the authors describe some of the ethical underpinnings of truth-telling both in pediatrics and more generally, as well as important features of the disclosure of health care information to children. They then provide arguments both for and against withholding information from children when that is requested by parents, examining some common arguments made for each of these strategies in the literature and in clinical practice. After touching upon unique considerations regarding disclosure of different types of information to minors, the authors close by providing practical guidance on how clinicians can respond when parents explicitly request to not tell their child information about their health and/or health care.