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Related Experiment Videos

Ethical problems in pediatric critical care: consent.

Christine A Zawistowski1, Joel E Frader

  • 1University of Pittsburgh School of Medicine, PA, USA.

Critical Care Medicine
|May 29, 2003
PubMed
Summary

Children may be more capable of medical decision-making than previously believed. Healthcare professionals should seek patient assent in pediatric intensive care units, alongside parental informed consent.

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Area of Science:

  • Pediatric Intensive Care Medicine
  • Bioethics
  • Medical Law

Background:

  • Informed consent is a critical ethical consideration in pediatric intensive care.
  • Historically, children have been deemed legally incompetent to make medical decisions, with parents/guardians holding decision-making authority.
  • Emerging evidence suggests children possess greater capacity for medical decision-making than traditionally acknowledged.

Purpose of the Study:

  • To explore the evolving understanding of informed consent and assent in pediatric intensive care.
  • To examine the ethical and legal implications of involving children in their medical decision-making processes.
  • To provide recommendations for healthcare professionals regarding patient participation in care decisions.

Main Methods:

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  • This study is a review of ethical principles and legal precedents concerning informed consent in pediatric intensive care.
  • It synthesizes empirical research on children's decision-making capacity.
  • It analyzes scholarly discourse on parental permission and child assent.

    • Main Results:

    • Children's capacity to participate in medical decision-making is increasingly recognized.
    • A shift towards seeking child assent, in addition to parental informed consent, is advocated by some scholars.
    • Consultation with adolescent patients is recommended, with consideration for involving younger children when appropriate.

    Conclusions:

    • Healthcare providers should re-evaluate the extent to which children can and should be involved in their medical care decisions.
    • Integrating child assent into the informed consent process respects patient autonomy and may improve care outcomes.
    • Ethical guidelines and legal frameworks may need to adapt to reflect children's growing capacity for participation in healthcare.