CONSENT IN PAEDATRIC PATIENT

1. CONSENT IN PAEDATRIC PATIENT

2. CONSENT • Consent is the granting to someone the permission to do something they would not have the right to do without such permission. (Malaysian Dental Council) • For consent to be valid, the patient must have received enough information to make the decision.

3. CONSENT • A consent is not valid if the patient: • does not know what is planned, or • knows what is planned but has not agreed • Valid consent to treatment can only be given by an individual who has the legal capacity (above 18 years of age) to give consent.

4. TYPES OF CONSENT

5. VALID CONSENT (MDC) • The practitioner should explain to the patient: • the treatment proposed; • the risks involved in the treatment; • advantages and limitations of that treatment • Alternative treatments and costs. • The practitioner should not: • give guarantees • make unreasonable promises about outcomes of treatment • For minors (below 18 years), written consent must be obtained from parents or legal guardian • If general anaesthetic or sedation is to be given, all procedures must be explained to the patient.

6. Definition of Parental Responsibility • All the rights, duties, powers, responsibilities and authority which by law a parent of a child has in relation to the child and his property (The Children Act 1989- UK) • “A person that has entitled to agree to treatment on behalf of a child up to age 18” (NICE)

7. Who has parental responsibility?

9. ISSUES

11. Who can give consent to children for treatment? • Person who has parental responsibilityare entitled to agree to treatment on behalf of a child up to age 18 • Parents are expected to make health care decisions for their childrenbased on what they feel is in a child’s “welfare” or “best interests”. • Butit’s still a good idea to involve children as much as possibleeven whenthey’re not old enough to make decisions completely on their own • children can still play a part in decisions about their health care. • Themore they’re involved, the more likely they are to feel positive abouttreatment.

12. When can children give consent forthemselves? 16-18 year olds • Once children reach the age of 16, they can agree to examination or • treatment just like adults. People providing health care do not then • have to ask you for consent as well. Under 16s • The rules say that children under 16 may still be able to give consent • for themselves, provided they are mature enough to understand fully • what is involved.

13. So who gives consent – child or parents? • A lot depends on the seriousness or difficulty of the proposed treatment. • Although the child might be grown-up enough to consent to a meningitis vaccination, for instance, it might be too much to expect him or her to grasp all they need to know for consenting to a heart operation. • Even if the child is grown-up enough to give consent independently, people providing treatment will still encourage them to involve the parents in their decision. • However, if children refuse to share information with parents, health care professionals must normally respect their wishes.

14. Reference • Guideline on informed consent; American Academy of Pediatric dentistry; 2009 • NICE