Psychiatric Bulletin (2002) 26: 117-118. doi: 10.1192/pb.26.3.117
© 2002 The Royal College of Psychiatrists
Psychiatric Bulletin (2002) 26: 117-118
© 2002 The Royal College of Psychiatrists
Consent, Rights and Choices in Health Care for Children and Young People
By the British Medical Association
Angela Hassiotis, Clinical Senior Lecturer
Royal Free and University College Medical School, Department of
Psychiatry and Behavioural Sciences, Wolfson Building, 48 Riding House Street,
London W1N 8AA
London: BMJ Books. 2001. 266 pp. £19.95 (pb) (BMA members
£18.95).
ISBN: 0-7279-1228-3.
I welcome this book as an important and timely addition to the topic of
applied ethics. In recent years health professionals increasingly have had to
negotiate a minefield of ethical dilemmas
vis-à-vis their patients. The
plethora of available treatment options has caused ethical issues pertaining
to research and clinical practice to become extremely
complicated.
Currently, children are expected to take part in decision-making and to be
assisted in doing so. Although ultimately it is the parents' or guardians'
task to settle on action that is deemed to be in the best interests of young
children, it is also appropriate to take into account the wishes and thoughts
of those (competent) children. For older children most health professionals
will have become familiar with the phrase ‘Gillick competence’,
which indicates that an adolescent can consent to individual health choices
and for his or her views to be listened to. Youngsters are entitled to
confidentiality and to be told the truth about their medical condition.
A particularly valuable aspect of the book is that all the ethical problems
that are relevant to children are dealt with in one publication. The project
organisers have received contributions by a select group of experts in child
health and ethics. The book discusses with authority most aspects of ethical
treatment in child health care, including assessment of competence, research,
and detention under the Mental Health Act 1983 of children and young persons
up to the age of 18 years. A whole chapter is given to summarising points of
good practice, several core terms are defined and a list of legal cases is
provided. Key points that are raised in each chapter are reviewed at the end,
along with extensive references. A useful appendix provides further access to
public agencies for supplementary information.
As is customary, the style of writing is easy to follow, although a minor
complaint is that the layout appears somewhat overcrowded. The target audience
of the book rightly is the working health professional, who requires clear
guidance on how to resolve ethical problems as they arise in child
consultation and research.
