Relational ethics and the justification of parental permission in pediatrics

Beyond legal requirement, why should physicians obtain parental permission to treat a pediatric patient? Children are not the property of their parents, physicians have the relevant medical expertise, and a physician's primary responsibility is to the child, not the parents. In response, scholars have provided several instrumental reasons grounded in the parent-child relationship beyond legal obligation (e.g., parents know their child best; parents can resist substandard care; doing so fosters parental buy-in). While I agree with these reasons, they are not enough to support parental permission in every case in which it should be obtained. Accordingly, I defend a further reason: physicians should obtain parental permission as part of their role responsibility in the physician-parent relationship. I delineate this largely neglected but morally significant relationship and explain why it helps account for physician responsibilities toward parents in pediatric care.