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Children and bioethics: clarifying consent and assent in medical and research settings

Merle Spriggs1,2

  • 1Children's Bioethics Centre, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3052, Australia.

British Medical Bulletin
|February 1, 2023
PubMed

Insights

Pediatric consent is complex. This review clarifies child assent, consent, capacity, and competence, guiding medical and research interventions for children. It explores when children can provide independent consent.

Area of Science:

  • Pediatric Bioethics
  • Child Health Law
  • Clinical Research Ethics

Background:

  • Pediatric consent for medical and research interventions presents significant ethical and practical challenges.
  • Clinicians and researchers grapple with determining who provides consent and when a child can offer independent consent.

Purpose of the Study:

  • To clarify the justification for medical or research interventions involving children.
  • To define the roles of consent, assent, capacity, and competence in pediatric decision-making.

Main Methods:

  • The study is based on a comprehensive literature review.
  • Analysis of existing ethical frameworks and legal precedents regarding pediatric consent.

Main Results:

  • Engaging children in decisions affecting them is ethically supported.
  • Significant controversy exists regarding the role of competence/capacity and sole consent by minors.

Conclusions:

  • Addressing flawed assumptions about child competence/capacity is crucial.
  • Further research is needed to develop frameworks for children's well-being during the transition to adulthood, accommodating their interests in decision-making.
Abstract

Keywords:
assentbioethicscapacitychildrencompetencedecisional authoritydissentinformed consent

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