Bioethics Blogs

When Doctors and Parents Disagree Ethics, Paediatrics and the Zone of Parental Discretion

A new book explores ethical decision­making when clinicians and parents disagree about medical  treatment for a child.  

When Doctors and Parents Disagree Ethics, Paediatrics and the Zone of Parental Discretion develops and explores a concept called the zone of parental discretion: an ethical tool that aims to balance children’s wellbeing and parents’ rights to make medical decisions for their children. 

Written by experienced clinical ethicists and paediatric clinicians, this book offers ethical analysis and practical guidance based on real­life clinical cases. It aims to assist doctors, nurses, allied health professionals and clinical ethics staff to deal with these ethically challenging situations.

In paediatrics, clinicians and parents sometimes disagree about the appropriate medical treatment for a child. Parents can prefer an option that differs from the clinician’s recommendation. When should the parents’ decision about their child’s medical treatment be overridden?

Part I – An ethical tool: the zone of parental discretion

1.  The zone of parental discretion

2.  Within the ZPD: focusing on harm and children’s interests

Part II – Roles of doctors and parents in decision­making

3. So, do we really need doctors anyway? Information, expertise and the changing dynamic between doctors and families

4. Who should decide for critically ill neonates and how? The grey zone in neonatal treatment decisions

5. Parental rights: who has them and what are their limits?

Part III – Clinicians encountering parental refusals

6. The rehabilitation context: the ZPD and ongoing care questions 

7. When a parental refusal of treatment is only distantly or unpredictably life ­threatening to the child

8. Parental discretion and medical tests for children

Part IV – Clinicians encountering parental requests for treatment


The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.