Abstract
Twenty couples whose newborn baby had an open myelomeningocoele were given a detailed account of the baby's clinical state and likely future by the paediatrician. They each said how they wanted their child treated. I believe a high percentage of parents would like to be involved in the decision on how to treat their spina bifida baby. When parents are given all the facts (including an interpretation of the clinical assessment) by an experienced doctor—and who better for the job than the paediatrician—then the chances of reaching the right decision for child and family which that joint consultation offers are greater than when the doctor has to act as adviser and sole adjudicator.