Informed Consent: Pediatric Patients, Adolescents, and Emancipated Minors

  • Irini N. KolaitisEmail author
  • Joel E. Frader


Permission to perform medical procedures on children poses special ethical and legal considerations. Decision makers must focus on the child’s interests and attend to cognitive and emotional factors affecting developing children. As children grow, adults must increasingly include them in decisions about their health care. Decisions made by clinicians with parents or guardians on behalf of children require a higher, more rational basis, than decisions one may make for one’s self as an autonomous adult.


Pediatrics Informed Consent Physician-Patient Relationship Informed Refusal Assent Parental Permission Emancipated Minor Mature Minor 


  1. 1.
    Faden RR, Beauchamp TL, King NM. A history and theory of informed consent. New York: Oxford University Press; 1986.Google Scholar
  2. 2.
    Beauchamp TL, Childress JF. Principles of biomedical ethics. New York: Oxford University Press; 2001.Google Scholar
  3. 3.
    Schloendorff v. Society of New York Hospital. NE1914. p. 92.Google Scholar
  4. 4.
    Salgo v. Leland Stanford etc. Bd. Trustees. P 2d: Cal: Court of Appeal, 1st Appellate Dist., 1st Div.; 1957. p. 170.Google Scholar
  5. 5.
    Berg JW, Appelbaum PS, Lidz CW, Parker LS. Informed consent: legal theory and clinical practice. 2nd ed. New York: Oxford University Press; 2001.Google Scholar
  6. 6.
    Bartholome WG. Informed consent, parental permission, and assent in pediatric practice. Pediatrics. 1995;96(5):981–2.PubMedGoogle Scholar
  7. 7.
    Levetown M. Communicating with children and families: from everyday interactions to skill in conveying distressing information. Pediatrics. 2008;121(5):e1441–60.CrossRefPubMedGoogle Scholar
  8. 8.
    Brock DW. Children’s competence for health care decisionmaking. Children and Health Care: Kluwer Academic Publishers, Dordrecht, The Netherlands and Norwell, MA; 1989. p. 181–212.Google Scholar
  9. 9.
    Weithorn LA, Campbell SB. The competency of children and adolescents to make informed treatment decisions. Child Dev. 1982;53(6):1589–98.CrossRefPubMedGoogle Scholar
  10. 10.
    King NM, Cross AW. Children as decision makers: guidelines for pediatricians. J Pediatr. 1989;115(1):10–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Koocher GP, DeMaso DR. Children’s competence to consent to medical procedures. Pediatrician. 1990;17(2):68–73.PubMedGoogle Scholar
  12. 12.
    Harrison C, Kenny NP, Sidarous M, Rowell M. Bioethics for clinicians: 9. Involving children in medical decisions. Can Med Assoc J. 1997;156(6):825–8.Google Scholar
  13. 13.
    Alderson P, Sutcliffe K, Curtis K. Children’s competence to consent to medical treatment. Hastings Cent Rep. 2006;36(6):25–34.CrossRefPubMedGoogle Scholar
  14. 14.
    Sigman GS, O’Connor C. Exploration for physicians of the mature minor doctrine. J Pediatr. 1991;119(4):520–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Coleman DL, Rosoff PM. The legal authority of mature minors to consent to general medical treatment. Pediatrics. 2013;131(4):786–93.CrossRefPubMedGoogle Scholar
  16. 16.
    Cady FC. Emancipation of minors. Conn L Rev. 1979;12:62.Google Scholar
  17. 17.
    Horowitz RM, Davidson HA. Legal rights of children. Colorado Springs: Shepard’s/McGraw-Hill; 1984.Google Scholar
  18. 18.
    Holder AR. Legal issues in pediatrics and adolescent medicine. New Haven: Yale University Press; 1985.Google Scholar
  19. 19.
    Truman v. Thomas. P 2d: Cal: Supreme Court; 1980. p. 902.Google Scholar
  20. 20.
    Saskatchewan (Minister of Social Services) v. P.(F.). DLR (4th)1990. p. 134.Google Scholar
  21. 21.
    Ridgway D. Court-mediated disputes between physicians and families over the medical care of children. Arch Pediatr Adolesc Med. 2004;158(9):891–6.CrossRefPubMedGoogle Scholar
  22. 22.
    Cronin DC, Squires J, Squires R, Mazariegos G, Lantos JD. Parental refusal of a liver transplant for a child with biliary atresia. Pediatrics. 2013;131(1):141–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Dixon JL, Smalley MG. Jehovah’s Witnesses: the surgical/ethical challenge. JAMA. 1981;246(21):2471–2.CrossRefPubMedGoogle Scholar
  24. 24.
    Thomas JM. Meeting the surgical and ethical challenge presented by Jehovah’s Witnesses. Can Med Assoc J. 1983;128:1153–4.PubMedPubMedCentralGoogle Scholar
  25. 25.
    In re EG. NE 2d: Ill: Supreme Court; 1989. p. 322.Google Scholar
  26. 26.
    McCullough LB, Jones JW, Brody BA, editors. Surgical ethics. New York: Oxford University Press; 1998.Google Scholar
  27. 27.
    Jones JW, McCullough LB. Consent for residents to perform surgery. J Vasc Surg. 2002;36(3):655–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Nwomeh BC, Waller AL, Caniano DA, Kelleher KJ. Informed consent for emergency surgery in infants and children. J Pediatr Surg. 2005;40(8):1320–5.CrossRefPubMedGoogle Scholar
  29. 29.
    Sirbaugh PE, Diekema DS. Consent for emergency medical services for children and adolescents. Pediatrics. 2011;128(2):427–33.CrossRefGoogle Scholar
  30. 30.
    Schwartz JA. Innovation in pediatric surgery: the surgical innovation continuum and the ETHICAL model. J Pediatr Surg. 2014;49(4):639–45.CrossRefPubMedGoogle Scholar
  31. 31.
    Luks FI, Johnson A, Polzin WJ, NAFT Network. Innovation in maternal–fetal therapy: a position statement from the North American Fetal Therapy Network. Obstet Gynecol. 2015;125(3):649–52.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Pediatrics, Division of Hospital Based MedicineAnn & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Department of Pediatrics, Division of Academic General Pediatrics and Primary Care, Medical Humanities and BioethicsAnn & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of MedicineChicagoUSA

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