Incorporating parental values in complex medical decisions for young children is important but challenging. In this Review, we explore what it means to incorporate parental values in complex paediatric and perinatal decisions. We provide a narrative overview of the paediatric, ethics, and medical decision-making literature, focusing on value-based and ethically complex decisions for children who are too young to express their own preferences. We explain key concepts and definitions, discuss paediatric-specific features, reflect on challenges in learning and expressing values for both parents and health-care providers, and provide recommendations for clinical practice. Decisional values are informed by global and external values and could relate to the child, the parents, and the whole family. These values should inform preferences and assure value-congruent choices. Additionally, parents might hold various meta values on the process of decision making itself. Complex decisions for young children are emotionally taxing, ethically difficult, and often surrounded by uncertainty. These contextual factors make it more likely that values and preferences are initially absent or unstable and need to be constructed or stabilised. Health-care professionals and parents should work together to construct and clarify values and incorporate them into personalised decisions for the child. An open communication style, with unbiased and tailored information in a supportive environment, is helpful. Dedicated training in communication and shared decision making could help to improve the incorporation of parental values in complex decisions for young children.

将父母的价值观纳入幼儿的复杂医疗决策中很重要，但也具有挑战性。在这篇综述中，我们探讨了将父母价值观纳入复杂的儿科和围产期决策中意味着什么。我们对儿科、伦理学和医疗决策文献进行了叙述性概述，重点关注为年龄太小而无法表达自己偏好的儿童做出基于价值和伦理复杂的决策。我们解释关键概念和定义，讨论儿科特定特征，反思父母和医疗保健提供者在学习和表达价值观方面的挑战，并为临床实践提供建议。决策价值观受到全球和外部价值观的影响，可能与孩子、父母和整个家庭有关。这些价值观应该告知偏好并确保价值观一致的选择。此外，父母可能对决策过程本身持有不同的元价值观。对于幼儿来说，复杂的决定会带来情感上的负担、道德上的困难，而且常常充满不确定性。这些背景因素使得价值观和偏好更有可能最初不存在或不稳定，需要构建或稳定。医疗保健专业人员和家长应共同努力构建和澄清价值观，并将其纳入儿童的个性化决策中。开放的沟通方式以及在支持性环境中提供公正且量身定制的信息是有帮助的。沟通和共同决策方面的专门培训有助于更好地将父母的价值观纳入幼儿的复杂决策中。