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“Who Speaks for the Child?” Consent, Assent, and Confidentiality in Pediatric Dermatology

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Dermatoethics

Abstract

Parents have the ultimate legal authority to make medical decisions for their children. In cases where there is disagreement between parents and physician, or between both parents, the physician should listen respectfully to the parents’ concerns and try to reach a mutually satisfactory consensus. In cases where this is not possible, the physician has an ethical obligation to advocate for the best interests of the child, while recognizing the legal authority of the parent(s) or legally authorized representative. As children mature, they should be allowed to have a greater voice in medical decisions, a process known as assent. Especially in the case of elective medically unnecessary procedures, such assent or dissent, while not legally required or binding, should be given considerable weight. There are well-recognized exemptions from the need for parental consent for minors. This chapter deals with the ethical and legal principles that are relevant to medical decision–making involving the parent–child–physician triad.

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References

  1. Kopelman LM. The best interests standard as threshold, ideal, and standard of reasonableness. J Med Philos. 1997;22:271–89.

    PubMed  CAS  Google Scholar 

  2. Kopelman LM. The best interests standard for incompetent or incapacitated persons of all ages. J Law Med Ethics. 2007;35:187–96.

    Article  PubMed  Google Scholar 

  3. Committee on Bioethics, American Academy of Pediatrics. Informed consent, parental permission, and assent in pediatric practice. Pediatrics. 1995;95:314–7.

    Google Scholar 

  4. Diekema DS. Boldt v. boldt: a pediatric ethics perspective. J Clin Ethics. 2009;3:251–7.

    Google Scholar 

  5. Yousuf RM, Fauzi RM, How SH, Rasool AG, Rehana K. Awareness, knowledge and attitude towards informed consent among doctors in two different cultures in Asia: a cross-sectional comparative study in Malaysia and Kashmir, India. Singapore Med J. 2007;48:559–65.

    PubMed  CAS  Google Scholar 

  6. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: ethical principles and guidelines for the Protection of Human Subjects of Research. Office of the Secretary, Department of Health, Education, and Welfare, Apr 18 1979.

    Google Scholar 

  7. http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf. Accessed 4 Apr 2011.

  8. Maradiegue A. Minors’ rights versus parental rights: review of legal issues in adolescent health care. J Midwifery Women Health. 2003;48:170–7.

    Article  Google Scholar 

  9. Fisher-Jeffes L, Barton C, Finlay F. Clinicians’ knowledge of informed consent. J Med Ethics. 2007;33:181–4.

    Article  PubMed  Google Scholar 

  10. Sigman G, Silber TJ, English A, Gans Epner JE. Confidential health care for adolescents: position paper of the Society for Adolescent Medicine. J Adolesc Health. 1997;21:408–15.

    Article  PubMed  CAS  Google Scholar 

  11. Kopelman LM. Children and bioethics: uses and abuses of the best-interests standard. Clinicians’ knowledge of informed consent. J Med Philos. 1997;22:213–7.

    PubMed  CAS  Google Scholar 

  12. Bower RE, Graham EA, Tonlinson KM. The natural history of the strawberry nevus. Arch Dermatol. 1960;82:667–80.

    Article  Google Scholar 

  13. Bruckner AL, Frieden IL. Hemangiomas of infancy. J Am Acad Dermatol. 2003;48:477–93.

    Article  PubMed  Google Scholar 

  14. Davis D. Boldt v. Boldt. J Clin Ethics. 2009;20:241–3.

    PubMed  Google Scholar 

  15. http://single-parenting.families.com/blog/single-parent-family-stats-from-the-2000-us-census. Accessed 2 Apr 2011.

  16. http://seniorliving.about.com/od/grandparents/a/grandparents_da.htm. Accessed 2 Apr 2011.

  17. McAbee GN, Committee on Medical Liability and Risk Management, American Academy of Pediatrics. Consent by proxy for nonurgent pediatric care. Pediatrics. 2010;126:1022–31.

    Article  PubMed  Google Scholar 

  18. Ford C, English A, Sigman G. Confidential health care for adolescents: position paper of the Society for Adolescent Medicine. J Adolesc Health. 2004;35:1–8.

    Google Scholar 

  19. Morreale MC, Kapphahn CJ, Elster AB, et al. Access to health care for adolescents and young adults: position paper of the Society for Adolescent Medicine. J Adolesc Health. 2004;35:342–4.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Center for Dermatology for Children and Young Adults, Eagan, MN, USA

    Kenneth E. Bloom

  2. Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN, USA

    Kenneth E. Bloom

  3. Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI, USA

    Lionel Bercovitch

Authors
  1. Kenneth E. Bloom
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  2. Lionel Bercovitch
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Correspondence to Lionel Bercovitch .

Editor information

Editors and Affiliations

  1. Brown University, Providence, 02912, Rhode Island, USA

    Lionel Bercovitch

  2. Brown University, Providence, 02912, Rhode Island, USA

    Clifford Perlis

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© 2012 Springer-Verlag London Limited

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Bloom, K.E., Bercovitch, L. (2012). “Who Speaks for the Child?” Consent, Assent, and Confidentiality in Pediatric Dermatology. In: Bercovitch, L., Perlis, C. (eds) Dermatoethics. Springer, London. https://doi.org/10.1007/978-1-4471-2191-6_5

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  • DOI: https://doi.org/10.1007/978-1-4471-2191-6_5

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2190-9

  • Online ISBN: 978-1-4471-2191-6

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