Children’s Competence to Consent to Medical Treatment (Cover Story)

Children's Competence to Consent to Medical Treatment (Cover Story)

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 Bioethics is still dominated, though, by outdated Piagetian age-stage theories of child development that tend to emphasize children’s ignorance, inexperience, and inability to make truly informed autonomous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, as if the mind and conscience grow as slowly as the body. (1) A few years ago, for instance, a review of literature on informed consent, published in these pages, included no examples of studies involving people less than eighteen years of age. (2) If, as Locke and Kant held, children are prerational and premoral, like animals or machines, then their views can hardly be informed or trustworthy, and their responses would be either mindless compliance or irrational resistance. (3) 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 (also known as juvenile or type 1) diabetes. (4)

Children's Competence to Consent to Medical Treatment (Cover Story)

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