Chair of Nursing, Women’s & Children’s Hospital, University of South Australia and Flinders University,Department of Nursing & Midwifery Research & Practice Development, Women’s & Children’s Hospital, Adelaide, South1AustraliaThe notions of ‘family-centred care’ and ‘parental participa-tion’, in relation to child health care in general and children’shospitalization in particular, continue to be the incantationsthat promise to transform our paediatric services – if only werepeat them earnestly and often enough. The problem of nosmall import is, of course, that unless we have a much moredetailed and sophisticated understanding of what thesesecurity-blanket terms might actually look like in practice,thentheyaredoomedtoalifeofvacuousutilityspentpaddingout the mission, vision and philosophy of care statements ofanypaediatricfacilityanywherethatwantstobeseentomakeall of the right noises. Hallstro¨m and Elander are to becommended for their sustained research that has consistentlysought to explore the intricacies of ‘parental participation’and helped us to understand the practices, perceptions,experiences and subtleties that comprise parents’, children’sand nurses’ experiences of hospitalization and care.In this paper they ask a variant of the crucial question,‘participation in what?’ and focus on how both the everydayand more clinical decisions are reached in the context of achild’s hospitalization. They are correct to highlight thesignificance of this issue for it impacts on children’s sense ofself and autonomy, parents’ and children’s satisfaction withcommunication, reactions to treatment and doubtless more(McCabe 1996). If we think ourselves momentarily into ananxious parent’s shoes it is not hard to imagine howunsettling and distressing it would be to feel that we were‘losing control’ of our child to the hospital. We would berightly concerned if we felt swept along by an army ofprofessionals who ‘knew best’ and who seemed unable orunwilling to listen to us, talk with us and at the very least, askus what we thought of possible or particular courses oftreatment for our sick child. Conversely, it may be no morereassuring to be in the hands of professionals who seemedincapable of advising or suggesting possible best options andwhose stock response to any question was that it was ‘yourdecision’ (at a time when your decision-making abilities maywell not be at their sharpest).However I do have some qualms about various aspects ofthis paper. I should say at the outset that these concerns donot apply only to this paper but that they have a widerapplicability across much qualitative research and indeed Iand many other interpretive researchers have probably falleninto similar traps. The paper reveals a structural issue forqualitative researchers and that is how to get the balanceright between the various necessary aspects of a researchreport. My sense is that less than two pages of a nine pagepaper devoted to findings or results is probably inadequateand leaves the authors open to the criticism that such findingsare likely to be thin or inconsequential.The paper’s central issue – decision-making, seems to havebeen introduced into the study as if it were largely self-explanatory and almost unproblematic. The nature of whatconstitutes ‘decisions’ seems unexplored as we move straightintolookingathowthesearemade.Aproblemhereisthatthismay lead us to see decisions as a fairly one-dimensionalconcept and simply something that is made or not made bysomeone or other. A more critical and questioning approachto the analysis of decisions might suggest that decision-making is much more of a complex perceptual social processthanitisaneventtobeobservedandcountedoff.‘Unpacking’this phenomena more closely would surely reveal otherdimensionsofdecision-makingthatseemtohavebeenglossedover or assumed here (see e.g. Young et al. 2003).