Children's assent within clinical care: A concept analysis.

Area of Science:

• Bioethics
• Pediatric Healthcare
• Medical Decision-Making

Background:

• Children's involvement in healthcare decisions is increasingly emphasized.
• Assent, or seeking a child's agreement, is a key component of this involvement.
• However, the precise definition and application of assent in clinical practice remain debated.

Purpose of the Study:

• To analyze the concept of assent in pediatric healthcare.
• To identify different perspectives on assent and its practical implementation.
• To explore the ethical implications and theoretical gaps surrounding children's assent.

Main Methods:

• Instrumentalist concept analysis of 58 relevant articles.
• Joint identification of themes through a deliberative process.
• Focus on understanding the multifaceted nature of assent in clinical care.

Main Results:

• Two primary perspectives on assent emerged: as specific agreement and as an ongoing interactive process.
• Significant variation exists in standards for applying assent.
• The concept of dissent was notably absent, particularly in high-stakes medical situations.

Conclusions:

• Gaps persist in the theory and practical application of children's assent.
• Further research is needed to develop practical standards and evidence-based guidelines.
• Ethical considerations include promoting autonomy, minimizing harm, and respecting children's rights.