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Informed Consent in Pediatric Anesthesia: A Narrative Review
Max M Feinstein1, Anthony E Pannunzio2, Samuel Lobell3
1From the School of Medicine, Case Western Reserve University, Cleveland, Ohio.
Anesthesia and Analgesia
|August 17, 2018
Summary
Informed consent for pediatric anesthesia research primarily focuses on parents, with limited studies on children
Area of Science:
- Anesthesiology
- Medical Ethics
- Pediatric Healthcare
Background:
- Informed consent in pediatric anesthesia presents ethical and legal challenges.
- Minor patients require nuanced approaches to decision-making based on age and development.
- Understanding stakeholder experiences is crucial for improving pediatric informed consent processes.
Purpose of the Study:
- To conduct a narrative review summarizing existing research on informed consent in pediatric anesthesia.
- To identify key themes and gaps in the literature regarding stakeholder involvement and outcomes.
Main Methods:
- Systematic search of Medline, Cochrane database, PROSPERO, and Clinicaltrials.gov.
- Inclusion/exclusion criteria focused on studies with informed consent as primary outcomes.
- Data extraction included study details, participant types, and outcome measures.
Main Results:
- Twenty-two articles were reviewed, covering various aspects of pediatric anesthesia informed consent.
- Parental understanding (7/22) and preferences (5/22) were most frequently studied.
- Studies involving pediatric patients directly (e.g., anxiety, understanding) were least common (1/22 each).
- Parents comprised 71% of study subjects, while pediatric patients represented only 13%.
Conclusions:
- Current research on pediatric anesthesia informed consent predominantly involves parents.
- There is a significant gap in studies focusing on the pediatric patient's perspective and direct involvement.
- Further research should prioritize understanding and incorporating the experiences of pediatric patients in the informed consent process.
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