Assessment of parents and young children (Children Act 1989)--a child psychotherapy point of view

Are we following the European charter? Children, parents and staff perceptions

BACKGROUND

In 1988, the European Association for Children in Hospital (EACH) established a charter of rights setting out the guiding principles for the treatment of children in hospital. Our aim was to ascertain whether children, parents and staff in a children's hospital believe the European Charter is conformed to.

METHODS

A total of 111 parents (response rate = 90%), 50 children (response rate = 100%), 61 nurses (response rate = 55%) and 41 doctors (response rate = 25%) agreed to participate. Questionnaires based on the 10 rights in the EACH Charter were administered to children, parents and staff.

RESULTS

The majority of children and parents were happy with the relationship they had with staff. However, the findings suggest that children, parents and staff are concerned with the lack of facilities in hospital, including parental accommodation, play, education, age-appropriate wards and lack of privacy. Staff felt that many children undergo unnecessary admission and treatment in hospital. Many staff are reluctant to discuss issues such as side effects of medications with patients and do not encourage children to ask questions. Contrary to expectations, clinicians were reluctant to consider children under 16 as capable of giving consent, and most parents and children felt that children should be over 17 and 18 respectively.

CONCLUSION

This paper highlights patients' and staff's perceptions regarding children's rights in hospital and discusses the changes needed to fully conform to the EACH Charter.

Children's competency to consent: an ethical dilemma

The application of the best interests principle in current legislation creates an ethical dilemma in relation to children's consent to treatment. The guiding principle of the UN Convention on the Rights of the Child (1989) symbolises a formal expression of children's participation rights. Children's rights to consent to treatment are granted on socially determined ideals of competency. Children's participation in health care is increasingly advocated in legislation but many barriers remain. Nurses can facilitate children's participation through communicating information and creating partnerships with children.