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Children's Competence to Consent to Medical Treatment

Protecting children may mean empowering them—involving them in their own treatment decisions as much as possible and helping them to understand them and take responsibility for them.

Philosophy, however abstract and analytical it is, can be only as sound as the social evidence and theories on which it relies. Bioethics is still dominated, though, by outdated Piagetian age-stage theories of child development that tend to emphasize children’s ignorance, inexperience, and inability to make truly informed autonomous decisions. Research has found, however, that some children do have the understanding, skill, and maturity to make decisions about their health care. Our purpose in this paper is to set out evidence we have gathered demonstrating that children can fulfill the criteria of competent decision-making as identified in some of the landmark documents on informed consent to medical research. We use examples from a study we conducted of children who have insulin-dependent diabetes.

Protecting children may mean empowering them—involving them in their own treatment decisions as much as possible and helping them to understand them and take responsibility for them.

Philosophy, however abstract and analytical it is, can be only as sound as the social evidence and theories on which it relies. Bioethics is still dominated, though, by outdated Piagetian age-stage theories of child development that tend to emphasize children’s ignorance, inexperience, and inability to make truly informed autonomous decisions. Research has found, however, that some children do have the understanding, skill, and maturity to make decisions about their health care. Our purpose in this paper is to set out evidence we have gathered demonstrating that children can fulfill the criteria of competent decision-making as identified in some of the landmark documents on informed consent to medical research. We use examples from a study we conducted of children who have insulin-dependent diabetes.

Priscilla Alderson, Katy Sutcliffe, and Katherine Curtis, "Children's Competence to Consent to Medical Treatment," Hastings Center Report 36, no. 6 (2006): 
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