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Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences

Mainstream law and ethics literature on consent to children’s surgery contrasts with moral experiences of children and adults observed in two heart surgery centres. Research interviews were conducted with 45 practitioners and related experts, and with 16 families of children aged 6 to 15, admitted f...

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Autores principales: Alderson, Priscilla, Bellsham-Revell, Hannah, Dedieu, Nathalie, King, Liz, Mendizabal, Rosa, Sutcliffe, Katy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240628/
https://www.ncbi.nlm.nih.gov/pubmed/36165269
http://dx.doi.org/10.1177/13674935221100419
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author Alderson, Priscilla
Bellsham-Revell, Hannah
Dedieu, Nathalie
King, Liz
Mendizabal, Rosa
Sutcliffe, Katy
author_facet Alderson, Priscilla
Bellsham-Revell, Hannah
Dedieu, Nathalie
King, Liz
Mendizabal, Rosa
Sutcliffe, Katy
author_sort Alderson, Priscilla
collection PubMed
description Mainstream law and ethics literature on consent to children’s surgery contrasts with moral experiences of children and adults observed in two heart surgery centres. Research interviews were conducted with 45 practitioners and related experts, and with 16 families of children aged 6 to 15, admitted for non-urgent surgery, as well as an online survey. Thematic data analysis was informed by critical realism and childhood studies. Impersonal adult-centric mainstream literature assumes young children cannot consent. It is based on dichotomies: adult/child, competent/incompetent, respect or protect children, inform or distract them, use time swiftly or flexibly, verbal/non-verbal communication, respect or control children and reason/emotion. Through their moral experiences, adults and children resolve these seeming dichotomies. Through understanding young children’s reasoning and emotions about complex distressing decisions related to heart surgery, adults share knowledge, control, trust and respect with them. They see children’s consent or refusal before non-urgent surgery as a shared personal moral experience within the child’s life course, beyond mere legal compliance. Adults help children to understand and ‘want’ the surgery that offers things they value: better health or to ‘be more like their friends’. If children are not convinced, sometimes surgery is postponed or occasionally cancelled.
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spelling pubmed-102406282023-06-06 Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences Alderson, Priscilla Bellsham-Revell, Hannah Dedieu, Nathalie King, Liz Mendizabal, Rosa Sutcliffe, Katy J Child Health Care Special Issue: Moral Experiences Mainstream law and ethics literature on consent to children’s surgery contrasts with moral experiences of children and adults observed in two heart surgery centres. Research interviews were conducted with 45 practitioners and related experts, and with 16 families of children aged 6 to 15, admitted for non-urgent surgery, as well as an online survey. Thematic data analysis was informed by critical realism and childhood studies. Impersonal adult-centric mainstream literature assumes young children cannot consent. It is based on dichotomies: adult/child, competent/incompetent, respect or protect children, inform or distract them, use time swiftly or flexibly, verbal/non-verbal communication, respect or control children and reason/emotion. Through their moral experiences, adults and children resolve these seeming dichotomies. Through understanding young children’s reasoning and emotions about complex distressing decisions related to heart surgery, adults share knowledge, control, trust and respect with them. They see children’s consent or refusal before non-urgent surgery as a shared personal moral experience within the child’s life course, beyond mere legal compliance. Adults help children to understand and ‘want’ the surgery that offers things they value: better health or to ‘be more like their friends’. If children are not convinced, sometimes surgery is postponed or occasionally cancelled. SAGE Publications 2022-09-27 2023-06 /pmc/articles/PMC10240628/ /pubmed/36165269 http://dx.doi.org/10.1177/13674935221100419 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Special Issue: Moral Experiences
Alderson, Priscilla
Bellsham-Revell, Hannah
Dedieu, Nathalie
King, Liz
Mendizabal, Rosa
Sutcliffe, Katy
Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences
title Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences
title_full Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences
title_fullStr Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences
title_full_unstemmed Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences
title_short Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences
title_sort children’s understanding and consent to heart surgery: multidisciplinary teamwork and moral experiences
topic Special Issue: Moral Experiences
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240628/
https://www.ncbi.nlm.nih.gov/pubmed/36165269
http://dx.doi.org/10.1177/13674935221100419
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