The child who refuses to undergo anesthesia and surgery: a case scenario-based discussion of the ethical and legal issues.
Article Type: Brief article
Subject: Anesthesia (Health aspects)
Anesthesiologists (Laws, regulations and rules)
Pediatrics (Laws, regulations and rules)
Author: Wright, Graeme
Pub Date: 04/01/2010
Publication: Name: European Archives of Paediatric Dentistry Publisher: European Academy of Paediatric Dentistry Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 European Academy of Paediatric Dentistry ISSN: 1818-6300
Issue: Date: April, 2010 Source Volume: 11 Source Issue: 2
Topic: Event Code: 930 Government regulation; 940 Government regulation (cont); 980 Legal issues & crime Advertising Code: 94 Legal/Government Regulation Computer Subject: Government regulation
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 277106739
Full Text: The child who refuses to undergo anesthesia and surgery: a case scenario-based discussion of the ethical and legal issues. H. Walker. Pediatric Anesthesia 2009;19:1017-1021

Summary. Situations where children refuse to undergo anesthesia and surgery can be challenging for anesthetists. Clear legal guidelines are lacking and decisions often need to be made with a degree of urgency. When a child refuses to cooperate with the induction of anesthesia, it is important to consider the autonomous capacity of the child, the presence of a legally valid consent from a suitable guardian, the urgency with which the surgery needs to proceed and the practical implications of proceeding without the child's cooperation. In this article, case scenarios are used to demonstrate how these considerations can be applied in practice. Comment. The child who refuses to undergo anaesthesia and/or dental treatment will not be unusual to any Paediatric Dentist. This paper focuses on the legal frameworks in place within New Zealand whilst drawing on UK legislation that has been instrumental in the consent debate. Regardless of the legal variations worldwide, these case based scenarios can be considered to universally serve as a clear reminder of the paramount importance of placing a child's best interests foremost in any situation of consent and assent. We are also reminded that in those situations where despite a lack of competency to make an autonomous decision, a child still has a right to have their views heard and considered.
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