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Objectives: This paper aims to highlight the evolution of informed consent in medical practice in general and pediatric practice in particular, as well as current international regulations on the involvement of children in decision-making. Material and methods: A literature review was conducted from Pub Med, Proquest Central, Scopus Elsevier, and Springer Link Journal databases for the period 2001 - 2022. Outcomes: Informed consent is the process by which clinical staff obtains patients' permission to perform invasive procedures. Serious discussions about the meaning and ethics of informed consent began in medicine, research, law, and philosophy only around 1972. For a pediatric patient, a natural response in medical decision making is to delegate authority to the parent or caregiver who is supervising them. In recent years there has been an increasing emphasis on involving the child in decisionmaking. The principle of autonomy is essential when discussing informed consent. Leading organizations in Australia, the UK, and the US have developed recommendations on involving children in decision-making. Pediatricians should share medical information with children and their families in ways that are helpful and empowering. This information should be complete, honest, and unbiased. However, these recommendations have no specific, non-prescriptive references, which demonstrate that in practice there is very little established practice of telling children the truth. Conclusions: this subject will always remain an extremely sensitive and challenging one for professionals, who will have to use all their knowledge and skills to ensure high-quality care for children. [ABSTRACT FROM AUTHOR]