Academic journal article The Hastings Center Report

In Hungary, Children Help Decide

Academic journal article The Hastings Center Report

In Hungary, Children Help Decide

Article excerpt

Traditionally, children below the age of majority have been presumed incapable of making decisions for themselves; thus parents have been given the power to consent to their children's medical treatment. At present, in almost all parts of the world, an individual is legally a minor and presumed incompetent until she or he has reached the age of at least eighteen; this is the case in Hungary.

Over the past decade several factors have weakened the presumption of the child's incapacity and opened the possibility for children to give valid consent. Importantly, we have come to recognize that age is not always a satisfactory measure of mental capacity.[1] Many pediatricians in Hungary now feel that they must involve their child patients in decision-making related to health care. And more and more pediatricians view the child's decisionmaking role as a larger issue than just the question of legal capacity to give informed consent independent of parental wishes. Pediatricians now realize that they must assess and enhance the decisional capacities of their child patients of different ages, and with the help of parents progressively involve children in the decisionmaking process as they mature.

Decisionmaking about health care by children requires the same abilities as those used by adults: understanding the medical information, considering or reasoning about it, and freely choosing among the options. Many children possess the capacity to take part in the decisionmaking process at some level; some children--mainly adolescents--possess all or nearly all the capacity to give truly informed consent regarding their health care. Only children who have reached the level of formal logical thinking will have an understanding that is relevant to medical decisionmaking. …

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