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Review
. 2021 Nov;22(4):335-341.
doi: 10.1177/1751143720969267. Epub 2020 Oct 29.

Should parents be asked to consent for life-saving paediatric interventions?

Affiliations
Review

Should parents be asked to consent for life-saving paediatric interventions?

Nathan K Gamble et al. J Intensive Care Soc. 2021 Nov.

Abstract

Informed consent, when given by proxy, has limitations: chiefly, it must be made in the interest of the patient. Here we critique the standard approach to parental consent, as present in Canada and the UK. Parents are often asked for consent, but are not given the authority to refuse medically beneficial treatment in many situations. This prompts the question of whether it is possible for someone to consent if they cannot refuse. We present two alternative and philosophically more consistent frameworks for paediatric proxy consent. The first allows meaningful consent (parents may say 'yes' or 'no' to treatment), provided that parents are medically informed/competent and intend the health and well-being of their child. In the second solution, medical practitioners or the state consent for treatment, with parents only being consulted to help give insight to the child's circumstances. While we contend that either of these two options is superior to the insincerity of the present paradigm, we suggest that the first solution is preferable.

Keywords: Jehovah's Witness; Proxy consent; blood transfusion; paediatric consent; vaccination.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Manson NC. Transitional paternalism: how shared normative powers give rise to the asymmetry of adolescent consent and refusal: transitional paternalism. Bioethics 2015; 29: 66–73. - PubMed
    1. Winters JP. When parents refuse: Resolving entrenched disagreements between parents and clinicians in situations of uncertainty and complexity. Am J Bioeth 2018; 18: 20–31. - PubMed
    1. Diekema DS. Parental refusals of medical treatment: the harm principle as threshold for state intervention. Theor Med Bioeth 2004; 25: 243–264. - PubMed
    1. Hauerwas S. Suffering presence: theological reflections on medicine, the mentally handicapped, and the church. Edinburgh: T. & T. Clark LTD, 1988.
    1. Pruski M, Gamble NK. Reasonable parental and medical obligations in pediatric extraordinary therapy. Linacre Q 2019; 86: 198–206. - PMC - PubMed