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A critical realist analysis of consent to surgery for children, human nature and dialectic: the pulse of freedom

Alderson, P; Sutcliffe, K; Mendizabal, R; (2020) A critical realist analysis of consent to surgery for children, human nature and dialectic: the pulse of freedom. Journal of Critical Realism 10.1080/14767430.2020.1733922. (In press).

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Abstract

Consent can only be voluntary, freely given and uncoerced. Can this legal adult standard also apply to children? High-risk surgery is seldom a wanted choice, but compared with the dangers of the untreated problem, surgery can become the least unwanted option. Critical realism helps to reveal explicit and hidden levels of informed and voluntary consent at empirical, actual and real levels, on the four planes of social being and through the four-stage dialectic. Instead of starting with the rational-legal adult patient standard of consent, and assessing how young children fail this, understanding of consent could start at the other end of life. What does innate physical-social-moral-intuitive human nature in the emotional embodied person tell us about the meaning and purpose of consent/refusal for self-preservation, for avoiding suffering and promoting wellbeing? This discussion paper considers examples of life-giving treatment for children, and ethical dilemmas including one of conjoined twins, when only one child could survive separation.

Type: Article
Title: A critical realist analysis of consent to surgery for children, human nature and dialectic: the pulse of freedom
DOI: 10.1080/14767430.2020.1733922
Publisher version: https://doi.org/10.1080/14767430.2020.1733922
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Agency, conjoined twins, emergence, ethical dilemmas, trust, voluntariness
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10093718
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