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Understanding, Wisdom and Rights: Assessing Children's Competence

Alderson, P; (1998) Understanding, Wisdom and Rights: Assessing Children's Competence. Journal of Social Sciences (India) pp. 157-172. Green open access

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Abstract

Traditionally, children have been identified as incompetent to consent to health treatment. In the mid-1980s English law changed. Although their welfare rights are generally accepted, their autonomy rights are tenuous, and disputed on the grounds of their incompetence. This paper examines children's competence, firstly in the current context of children's international and legal rights, and then through reviewing the history of their presumed incompetence. Growing evidence of children's competence is reported, drawing on examples from a recent empirical study of children having surgery in English hospitals. The advantages and problems of respecting children's competence are considered. One hundred and twenty orthopaedic patients aged 8 to 15 years, 54 boys and 66 girls, were interviewed in 4 hospitals: Westminster Children's; the Hospital for Sick Children at Great Ormond Street; the Royal National Orthopaedic at Stanmore, and the Royal Liverpool Children's Alder Hey. The age range is shown in table I. The childreni were having elective surgery for reasons shown in table II. The patients were already well informed, on average they had had 4 operations and 6 hospital admissions. The 6 accidents had occurred years earlier, leaving serious defects. Fifty eight patients had chronic disorders besides the specific problem being treated. Some disorders, such as cerebral palsy, were linked to the condition requiring surgery, others, such as diabetes, entailed separate but partly relevant hospital experience. There was a wide range of intelligence, and 8 children attended special schools for learning difficulties. One hundred and four mothers and 32 fathers, were also interviewed (for computer entries, couples' replies were counted as 1 entry). The 70 hospital professionals were: 6 surgeons, 10 physicians, 15 sisters and senior nurses, 6 ward nurses, 4 therapists, 5 social workers, 2 chaplains, 12 teachers, 4 play specialists, 5 psychologists and a child psychiatrist.

Type: Article
Title: Understanding, Wisdom and Rights: Assessing Children's Competence
Open access status: An open access version is available from UCL Discovery
Publisher version: http://www.krepublishers.com/index.html
Language: English
Additional information: This work is licensed under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 International License.
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/1493891
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