Lead
A physician leans toward a school-age child before a procedure and asks: "We're going to do this test — are you okay with that?" The child nods.
What does that nod mean? The parent has already provided legal consent, so nothing about the medical act turns on the child's response. Why ask at all?
The answer is not ceremony. Asking is a practice of treating the child as a person — a participant in what is happening to their own body. Pediatric medical ethics has spent more than 30 years working out what that practice should look like.