Children's competence to participate in healthcare decisions.

Advances in chronic and genetic disease management and technology create new challenges for healthcare professionals and patients in making informed decisions. The growing interest in children's involvement in their own healthcare decisions and a rebalancing of child and adolescent rights and responsibilities compounds these challenges. This article presents an overview of research and standards of practice regarding children's participation in research and healthcare decisions. Further research on children's competence to participate in healthcare decisions is recommended. Reasons for and against children's increased involvement in healthcare decisions are included. There is a preponderance of support for involving children in the process, and a dearth of well-articulated reasons to exclude them.