Age limits and shared decision-making in paediatric healthcare: an exploratory survey of the Young European Academy of Paediatrics

Despite guidance from the United Nations Convention on the Rights of the Child’s (UNCRC) affirming that children have the right to be heard in all matters affecting them, European legal and clinical practices for paediatric healthcare decision-making remain variable. This study examines the perspectives of members of the Young European Academy of Paediatrics (yEAP), the network of national junior paediatric representatives within the European Academy of Paediatrics (EAP), on age limits, harmonisation of age limits across Europe, and their exposure to formal training in shared decision-making with children. Between 26 May and 1 August 2025, a survey was distributed among paediatricians in training and young specialists who are active delegates of the yEAP. The survey evaluated their preferred minimum age limits across different healthcare domains, their views on harmonisation of age limits across Europe, and their exposure to formal training in shared decision-making with children. Data were analysed using descriptive statistics. The findings reveal a variation in preferred minimum age limits for paediatric healthcare across different domains. The results are based on perspectives of 20 participants from different countries in Europe. Most participants (70%) favoured standardising age limits across Europe. Participants noted a substantial lack of formal training (85%) in shared decision-making with children. Conclusion : This study highlights both opportunities and challenges in translating child rights frameworks into practice. Given the small sample size, findings are exploratory, underscoring the need for broader research and context-specific policy and training initiatives. What is known: • Guidance from the United Nations Convention on the Rights of the Child’s (UNCRC) affirms that children have the right to be heard in all matters affecting them. • Despite the guidance from frameworks like the UNCRC, variability persists in European legal and clinical practices regarding paediatric healthcare decision making. What is new: • The findings indicate that preferred minimum age thresholds for autonomous decision-making are not uniform but vary across healthcare domains. • Most participants favoured standardising age limits across Europe. • Participants noted a substantial lack of formal training in shared decision making with children.