Assent for treatment: clinician knowledge, attitudes, and practice. Pediatrics 2006 Aug;118(2):723-30
Date
08/03/2006Pubmed ID
16882829DOI
10.1542/peds.2005-2830Scopus ID
2-s2.0-33748415225 (requires institutional sign-in at Scopus site) 45 CitationsAbstract
OBJECTIVES: Our purpose for this work was to explore clinician knowledge, attitudes, and practice regarding assent for medical treatment and to compare current practice with existing American Academy of Pediatrics guidelines.
METHODS: One of the investigators administered a questionnaire to clinicians who perform procedures on children at an academic tertiary care pediatric hospital to assess knowledge of assent for medical treatment and familiarity with the American Academy of Pediatrics policy statement on assent and to measure clinician attitudes and approaches to consent/assent in pediatrics.
RESULTS: Of 35 clinicians enrolled, 23 (66%) had heard of the term "assent," and 9 (26%) of 35 were aware of the American Academy of Pediatrics policy statement on assent. Twenty five (74%) of 34 thought 1 of the main goals of assent was to educate the child. Only 12 (35%) of 34 included the element of seeking the child's agreement as a goal of assent. In practice, the element of explaining the proposed treatment was "always" included by 26 (74%) of 35. The element of seeking the child's agreement was "always" included by 9 (26%) of 35.
CONCLUSIONS: The clinicians in this study had limited explicit knowledge of the concept of assent for medical treatment and were largely unaware of the recommendations from the American Academy of Pediatrics. Their attitudes and practice reflected implicit acceptance of the importance of including children in discussions about their medical care and reluctance to give children decision-making authority. A model of medical decision-making for children that includes education but does not allow children to share decision-making authority may be more applicable to clinical practice than the current American Academy of Pediatrics-supported model of assent.
Author List
Lee KJ, Havens PL, Sato TT, Hoffman GM, Leuthner SRAuthors
George M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of WisconsinK Jane Lee MD Interim Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Steven R. Leuthner MD Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAge Factors
Attitude of Health Personnel
Child
Child, Preschool
Decision Making
Guideline Adherence
Health Knowledge, Attitudes, Practice
Humans
Informed Consent
Parents
Patient Acceptance of Health Care
Patient Rights
Patients
Pediatrics
Personal Autonomy
Physician-Patient Relations
Physicians
Practice Guidelines as Topic
Professional Practice
Psychology, Child
Societies, Medical
Truth Disclosure
