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Children's competence to participate in healthcare decisions
1International Center of Research for Women, Children and Families, School of Nursing, Center for Bioethics, University of Pennsylvania, Philadelphia, Pa., USA. beidls@nursing.upenn.edu
Insights
Children
Area of Science:
- Pediatric healthcare ethics
- Child rights in medical research
- Decision-making in pediatric care
Background:
- Technological advancements and improved chronic/genetic disease management present complex choices for patients and healthcare providers.
- Increasing emphasis on children's autonomy in healthcare decisions, alongside evolving rights and responsibilities, adds complexity.
Purpose of the Study:
- To review current research and standards for involving children in healthcare and research decisions.
- To explore the rationale for and against greater child participation in medical decision-making.
Main Methods:
- Literature review of research and practice standards.
- Analysis of arguments for and against children's involvement in healthcare decisions.
Main Results:
- Significant support exists for increasing children's participation in healthcare decisions.
- There is a lack of strong, well-defined reasons to exclude children from these processes.
Conclusions:
- Further investigation into children's capacity for healthcare decision-making is warranted.
- The trend favors greater inclusion of children in their medical care decisions, with limited justification for exclusion.
Abstract:
Advances in chronic and genetic disease management and technology create new challenges for healthcare professionals and patients in making informed decisions. The growing interest in children's involvement in their own healthcare decisions and a rebalancing of child and adolescent rights and responsibilities compounds these challenges. This article presents an overview of research and standards of practice regarding children's participation in research and healthcare decisions. Further research on children's competence to participate in healthcare decisions is recommended. Reasons for and against children's increased involvement in healthcare decisions are included. There is a preponderance of support for involving children in the process, and a dearth of well-articulated reasons to exclude them.