<p>Beyond legal requirement, why should physicians obtain parental permission to treat a pediatric patient? Children are not the property of their parents, physicians have the relevant medical expertise, and a physician’s primary responsibility is to the child, not the parents. In response, scholars have provided several instrumental reasons grounded in the parent–child relationship beyond legal obligation (e.g., parents know their child best; parents can resist substandard care; doing so fosters parental buy-in). While I agree with these reasons, they are not enough to support parental permission in every case in which it should be obtained. Accordingly, I defend a further reason: physicians should obtain parental permission as part of their role responsibility in the physician-parent relationship. I delineate this largely neglected but morally significant relationship and explain why it helps account for physician responsibilities toward parents in pediatric care.</p>