Figure.

How does integrating public health considerations relevant to COVID-19 impact shared decision making for children? Under all circumstances, there is a range of shared decision making based on the question, the stakeholders' goals and values. In traditional SDM counseling by pediatricians becomes more directive as interventions present children lower risks and higher benefits. In contrast, public health decision making prioritizes solidarity, justice and law, resulting in more physician directiveness when interventions present population benefits, fairly distributed burdens proportionate to benefits, and low risks/harms to child.