Assent for treatment: clinician knowledge, attitudes, and practice

Area of Science:

• Pediatric healthcare
• Medical ethics
• Child patient rights

Background:

• Assent for medical treatment is crucial for involving children in their care.
• Existing guidelines from the American Academy of Pediatrics (AAP) provide a framework for assent.
• Understanding clinician perspectives on assent is essential for improving pediatric patient care.

Purpose of the Study:

• To evaluate clinician knowledge, attitudes, and practices concerning medical treatment assent in children.
• To compare current clinical practices with established AAP guidelines on assent.
• To identify discrepancies between theoretical understanding and practical application of assent.

Main Methods:

• A questionnaire was administered to clinicians performing procedures on children at a pediatric hospital.
• The survey assessed knowledge of assent, familiarity with AAP policy, and attitudes towards consent/assent.
• Data were collected from 35 clinicians at an academic tertiary care center.

Main Results:

• Only 66% of clinicians had heard of "assent," and 26% were aware of the AAP policy.
• While 74% believed assent's goal was child education, only 35% included seeking child agreement.
• In practice, explaining treatment was common (74%), but seeking agreement was less so (26%).

Conclusions:

• Clinicians demonstrated limited explicit knowledge of assent and AAP recommendations.
• Practices indicated a willingness to include children in discussions but reluctance for shared decision-making.
• A model emphasizing education without shared authority may better align with current clinical practice than the AAP model.