title: Making sense of adolescent decision-making: challenge and reality.
abstract: Few topics in pediatric bioethics are as vexing as decision-making. Decision-making in pediatrics presents challenges for children, parents, and physicians alike. The related, yet distinct, concepts of assent and consent are central to pediatric decision-making. Although informed consent is largely regarded as a worthwhile adult principle, assent has been, and continues to be, mired in debate. Controversial subjects include a meaningful definition of assent; how old children should be to assent; who should be included in the assent process; parental permission; how to resolve disputes between children and their parents; the relationship between assent and consent; the quantity and quality of information to disclose to children and their families; how much and what information children desire and need; the necessity and methods for assessing both children's understanding of disclosed information and of the assent process itself; reconciling ethical and legal attitudes toward assent; and finally, an effective, practical, and realistically applicable decision-making model.
authors: Division of Pediatric Hematology/Oncology, The Herman and Walter Samuelson Children's Hospital at Sinai, 2401 West Belvedere Avenue, Baltimore, Maryland 21215-5271, USA. yunguru@lifebridgehealth.org
authors: Yoram
authors: Y
authors: Unguru
mesh_terms: D000293:Adolescent; D000295:Adolescent Medicine / Q000941:ethics / Q000331:legislation & jurisprudence; D003657:Decision Making; D030881:Disclosure; D006801:Humans; D008297:Male; D010290:Parents; D010817:Physician-Patient Relations; D000297:Psychology, Adolescent / Q000941:ethics / Q000331:legislation & jurisprudence; D011639:Public Opinion; D013736:Testicular Neoplasms / Q000523:psychology*