The concept of consent in the pediatric setting is complex and confusing. Clinicians and researchers want to know whose consent they should obtain, when a child can provide independent consent and how that is determined. The aim of this article is to establish what produces the justification to proceed with medical or research interventions involving children and the role of consent in that. I clarify concepts such as consent, assent, capacity and competence.
Merle is an experienced and respected pediatric researcher, who has written extensively on ethics issues in childhood health research. She has also participated in the national design of ethics guidance for responsible, respectful and lawful research in this space. In this open access piece she reflects on the question of who should consent before the participation of young people in research. Whilst there are undoubtedly questions of capacity and legality, there are also deeper questions of respect, agency and ethics. This is a recommended read for members of research ethics committees and researchers.
Engaging with children and involving them in decisions about matters that affect them is a good thing.
The role of competence or capacity and the question of when a child can provide sole consent.
Flawed assumptions around competence/capacity.
An account of children’s well-being that accommodates children’s interests during the transition to adulthood.
Merle Spriggs, Children and bioethics: clarifying consent and assent in medical and research settings, British Medical Bulletin, 2023;, ldac038, https://doi.org/10.1093/bmb/ldac038
Publisher (Open Access): https://academic.oup.com/bmb/advance-article/doi/10.1093/bmb/ldac038/7003311