<p>The article highlights the role of guardians as independent representatives of the rights of children, particularly when it comes to the difficult decision about treatment with psychotropic drugs in the context of inpatient youth welfare services. A&#xa0;qualitative interview study with six guardians reveals how complex and uncertain the assessment of the best interests of the child is—influenced by individual attitudes, institutional frameworks, and power and negotiation processes in the interdisciplinary field. The results show that for child-friendly decision-making structurally secured participation processes and better interprofessional cooperation that consistently incorporate the perspectives of young people are necessary.</p>