Issues of the principle of informed assent in pediatric medicine in Japan : Relation with UNCRC (UNITED NATIONS COMMITTEE ON THE RIGHTS OF THE CHILD)'s "GENERAL COMMENT No.7 (2005): Implementing child rights in early childhood"

  • YAMAMOTO Tomoko

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  • 日本の小児医療におけるInformed Assent理念の課題 : 国連子どもの権利委員会「一般的意見 No.7 乳幼児の権利」との関係を中心に

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This paper, on a holistic approach to ensure children's rights, discusses the issues of informed assent (I.A.) in pediatric care in Japan, including the UNCRC (UNITED NATIONS COMMITTEE ON THE RIGHTS OF THE CHILD)'s "GENERAL COMMENT No.7 (2005) on implementing child rights in early childhood". I.A. consists of two concepts: parental permission and patient assent, which are specific to pediatric care. In clinical practice, it is recommended that care for infants be provided based on "parental permission" alone. The principle of I.A., suggested by pediatricians in the United States, includes the statement, "Decision-making involving the health care of young parents should flow from responsibility shared by physicians and parents", which is neither consistent with the rights of child patients or provision of appropriate care, nor subject to any legal responsibility. General Comment No.7 defines infants as social actors, and early childhood as a critical period for the realization of all rights enshrined in the Convention on the Rights of the Child. Evaluating the potential of infants positively, the General Comment questions the restriction of infants' rights due to their lack of interactive ability, strongly advocating the protection of their rights. To introduce the concept of I.A., it is necessary for us to change our view of infants' potential and consider their immaturity as a rationale for ensuring their rights, while taking into account the viewpoint of children's rights and pediatricians' views of infants, including activeness and uniqueness, obtained from their clinical experience and research achievements. It is also necessary to discuss the effects of the rules stipulated by health care professionals.


  • Bioethics

    Bioethics 19 (1), 4-12, 2009

    Japan Association for Bioethics


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