OBJECTIVES To examine the association between characteristics of parents whose children are diagnosed with life-limiting conditions, trust in physicians, and problems in the shared decision making process. METHODS This study using data collected from parents whose children have life-limiting conditions and enrolled in Florida's State Title V Program. Telephone surveys were conducted using 266 random parents between November 2007 and April 2008. The Wake Forest Physician Trust Scale was used to measure parents' trust in physicians. The Decisional Conflict Scale (DCS) was used to measure conflicts in decision making, e.g., uncertainty and uninformed and ineffective choices. The total score of DCS to represent the magnitude of decisional conflicts. We conducted multivariate analyses to test whether parent's age, race, education, personality traits, and parent-report of children's health status were associated with physician trust and decisional conflicts. We tested whether greater trust in physicians was associated with less decisional conflicts after controlling for parental characteristics. RESULTS Parents with less than a high school education reported less trust in physicians as compared to parents with above a high school education (p<0.05). Hispanic parents were less likely to trust in their physicians and had more decisional conflicts than White parents (p<0.05). Parents with lower level of conscientiousness, emotional stability and openness to experiences were associated with less trust in physicians and more decisional conflicts as compared to their counterparts (p<0.05). Parents' age and children's health status were not significant factors of physician trust and decisional conflicts (p>0.05). Parents' trust in physicians were significantly related to conflicts in the decision-making process (p<0.05). CONCLUSIONS For children with life-limiting conditions, parents who were minority, less educated, and with negative personality traits reported less trust in physicians and more conflicts in the decision making process. Trust plays a significant role in parents' treatment decision making beyond the influence of parents' characteristics.