Twenty-eight years ago, Levine and Stray-Gundersen1 wrote a seminal piece for sports cardiologists. This commentary heralded the currently accepted approach to determining sports eligibility for athletes with heart disease and called attention to limitations of medical paternalism. As written, “The final decision…rests with the informed (athlete), who must synthesize this information…in light of his or her own goals and aspirations.”1 This statement eloquently summarizes patient-centered shared decision-making (SDM), which is now widely advocated.1 With this historical background, the recent public disclosures of Jared Butler,2 diagnosed with hypertrophic cardiomyopathy, being allowed entry into the National Basketball Association draft and the return-to-play of Christian Eriksen3 after cardiac arrest and implantable cardiac defibrillator placement are remarkable milestones.