Patient- and family-centered care (PFCC) promotes respect for patients and families, information sharing, shared decision making and care planning, and collaborative service delivery. It is one part of a movement towards participatory medicine that values patients’ and family members’ knowledge and experience, an outgrowth of the shift in recent decades toward prioritizing patient autonomy. When and how is striving to deliver inclusive care ethically complex? How should medicine accommodate families alongside patients, and what ethical challenges arise when trying to do so? With feedback and contributions from patients and family members, this theme issue of the AMA Journal of Ethics considers some of the ethical challenges of implementing PFCC.