Shared decision-making is widely accepted as the best approach for end-of-life decision-making. However, there is wide variation in how this is practiced and what the physician’s role is in this approach. The tenets of shared decision-making seek to protect patient autonomy, yet it is well-known that physicians can influence decision-making by either coercion, manipulation, or persuasion. Literature promotes the use of persuasion to help patients make the best decisions for themselves. However, the current descriptions of these three influences are limited to specific times of decision-making. Advance care planning has generated greater focus on preparing patients for decision-making before the need for clinical decisions arise. What remains unknown is how physicians participate in this process; how do physicians practice advance care planning? By drawing on the results of a qualitative multi-study project focusing on paediatricians’ approach to advance care planning, I propose that physicians shepherd parents of children with life-limiting conditions well before a clinical decision is needed. Shepherding is a subtle, open-ended process intended to influence parents by guiding their understanding of their child’s health and potential suffering in advance of decision-making. I argue that shepherding is distinct from the current known types of physician influence, and the intention of shepherding and its strategies are translatable to all physicians caring for patients of all ages with life-limiting conditions. From these findings, I propose how advance care planning should be practiced, and offer notes of the ethical merits and cautions when using shepherding in practice.