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Clinical decisions should be governed by knowledge, experience and patient preference. The influence of each of these domains varies depending upon the actual clinical question, setting, available information, and the power of our own experience and those of our patients to influence decisions. For example, in the acute care setting, when a young infant is ill, I have never had a parent participate actively in decision making. In general, most parents leave it to clinicians to provide the best possible care. However, the decision making process should change when a problem is more long-standing and there is uncertainty as to what should be done. This is particularly true for end of life decisions. Knowles and colleagues found that parents and health professionals place similar values on different aspects of quality of life and agree that there are states of health worse than death. Professor Alan Craft, former President of the
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