Assent From a Child Before

¶ … Assent from a Child

Before making any decisions I would do two things: first I'd put the needle away and calm the child down. I'd assess if the child's reaction were that of a normal seven years faced with having their blood drawn or if the reaction was beyond a normal seven-year-old. The child may not of understood what giving a blood sample required and needs more information.

If the child was acting like a normal seven-year-old, I would explain what the procedure is and what he could expect to see and feel. Additionally, I discuss with the child the purpose of the study and how it might help others like their self. I would then ask the child if he had any questions and ask if we could try again. If the child says no, I would inquiry if we might be able to try again in little while. If the child still says no, I would not proceed at that moment and would give the child an activity to reduce his stress and to step away from the situation causing him fear.

I would speak with the parents and arrange for an appropriate colleague to join us. Using the six recommended questions, we would jointly evaluate the situation:

Question 1: Is the child old enough to provide assent?

I interpret this question to mean is the child mature enough to provide assent. I would take into consideration that as a seven-year-old, the child would be in grade school and has had the opportunity to act independently in a supervised situations. I would ask the parent to present other situations in which the child had been frighten at first and over came their fear. If their had been prior experiences of success, I would consider proceeding but not until we had work through all of the questions.

Question 2: Are there creative strategies the investigators could implement in order to gain the child's cooperation?

I would ask if either parent would be willing to have a blood draw so the child could see for himself that the procedure sounds and looks scarier than it is. We could then ask the child again if he was willing to participate.

Question 3: Does the study off the prospect of direct benefit to the children enrolled?

Currently, there is no cure for the disease and we have not been told how the disease will impact his quality of life and if it will result in death. The study's longitudinal design may not produce results during his lifetime. I would need more information in order to access if the child would benefit directly.

Question 4: How severe is the child's fear? How insistent is he that he not be stuck?

I would use the conversation outlined in the second paragraph to evaluate his fear. I would also ask the parents for their assessment of his fear.

Question 5: Is there a way to alleviate the child's fear so that he can participate without using coercion or undue influence?