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Children in the hospital: issues of power and vulnerability
1Department of Nursing Research and Practice Development, Women's and Children's Hospital, Adelaide, University of South Australia, Australia.
Insights
Pediatric nurses
Area of Science:
- Pediatric Nursing
- Child Healthcare Ethics
- Bioethics
Background:
- Pediatric nurses' experiences reveal power imbalances between children and adults in healthcare settings.
- The principle of 'in the child's best interest' can inadvertently restrict children's autonomy in healthcare decisions.
- Existing practices may not align with the United Nations Convention on the Rights of the Child.
Purpose of the Study:
- To explore the lived experiences of pediatric nurses regarding children's involvement in healthcare decisions.
- To analyze how adult-centric decision-making impacts children's rights and autonomy.
- To identify conflicts between healthcare practices and children's rights principles.
Main Methods:
- Phenomenological study design.
- Qualitative data collection through interviews with pediatric nurses.
- Thematic analysis of nurse experiences.
Main Results:
- Unequal power dynamics are prevalent, with adults (parents, healthcare providers) making decisions for children.
- Children are presumed incompetent, lacking validation of their decision-making capacity.
- Consent for all patient care activities, not just major procedures, is crucial.
- Access to children's bodies and everyday practices may require re-evaluation for child protection and education.
Conclusions:
- Healthcare systems must re-evaluate practices to ensure children's rights to participate in decisions affecting their health.
- Promoting age-appropriate involvement for children in healthcare decisions is essential.
- Aligning pediatric nursing practices with international children's rights conventions is necessary.
Abstract:
Findings from a phenomenological study into the experience of pediatric nurses highlight the unequal power relationships between children and adults, including parents and health care providers. Based on the principle of 'in the child's best interest' this thinking has the potential to deny children an age appropriate right to be involved in health care decisions and may conflict with the tenets of the United Nations Convention on the Rights of the Child. Adults are presumed competent to make health care decisions, children are presumed incompetent without any validation as to whether the child has the knowledge and ability to make the decision. Consent does not only apply to major procedures, but to all patient care activities. The right of access to children's bodies is always in the hands of others and some everyday practices may conflict with protective behavior education.