Assent in Pediatric Patients

Self, Jean C.; Coddington, Jennifer; Foli, Karen J.; Braswell, Melanie L.

doi:10.1111/nuf.12206

Cited by 7 publications

(3 citation statements)

References 21 publications

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“…Most research on children’s assent addresses this concept in research ethics. However, within the past 25 years, there has been growing international recognition that the concept of assent has the potential to improve practices when used within clinical care (Katz et al, 2016; Koelch and Fegert, 2010; Olszewski and Goldkind, 2018; Self et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Children’s involvement in health care has been reported to have several positive ethical impacts (Belitz and Bailey, 2009; Leikin, 1983). Notably, children’s engagement in the care process contributes to develop their self-determination (Self et al, 2017). Conversely, if healthcare providers do not include children in the care process, opportunities to develop their decision-making capacities, essential skills to navigate the healthcare system, can be impacted (Deatrick et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

“…These criteria are presented as allowing for practitioners to adopt more collaborative practices with children and parents (Kurz et al, 2006). However, studies keep highlighting that the concept of assent is often misunderstood, unknown, or used without a defined standard by clinicians (Deatrick et al, 1990; Grootens-Wiegers et al, 2018; Koshy and Sisti, 2015; Pate, 2013; Self et al, 2017). Researchers who have conducted studies related to child assent within clinical care advocate for patient involvement in health care and show the benefits of this collaboration between clinicians, parents, and children, but they do not agree on the meaning or application of child assent (Adams and Levy, 2017; Angst and Deatrick, 1996; Coyne, 2008).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Children’s assent within clinical care: A concept analysis

Montreuil

Fortin²,

Racine³

2020

J Child Health Care

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Seeking children’s assent has been put forward as a way to foster children’s involvement in the healthcare decision-making process. However, the functions of the concept of assent within clinical care are manifold, and methods used to recognize children’s capacities and promote their involvement in their care remain debated. We performed an instrumentalist concept analysis of assent, with 58 included articles. Final themes were jointly identified through a deliberative process. Two distinct perspectives of assent were predominant: as an affirmative agreement for a specific decision and as part of a continuous, interactive process of care. Differing standards were provided as to how and when to apply the concept of assent. The concept of dissent was largely omitted from conceptions of assent, especially in situations for which children’s refusal would lead to severe health consequences. Ethical implications included fostering autonomy, reducing physical/psychological harm to the child, respecting the child as a human being, and fulfilling the universal rights of the child. There remain important gaps in the theory of assent and its desirable and possible practical implications. Practical standards are largely missing, and evidence supporting the claims made in the literature requires further investigation.

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