Miller Victoria A, Drotar Dennis, Kodish Eric
Department of Psychology, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-7123, USA.
Ethics Behav. 2004;14(3):255-95. doi: 10.1207/s15327019eb1403_3.
This narrative review summarizes the empirical literature on children's competence for consent and assent in research and treatment settings. Studies varied widely regarding methodology, particularly in the areas of participant sampling, situational context studied (e.g., psychological versus medical settings), procedures used (e.g., lab-based vs. real-world approaches), and measurement of competence. This review also identifies several fundamental dilemmas underlying approaches to children's informed consent. These dilemmas, including autonomy versus best interest approaches, legal versus psychological or ethical approaches, child- versus family-based approaches, and approaches that emphasize consent versus those that emphasize assent, have implications for the measurement of children's competence and interpretation of findings. Recommendations for future research in the area of children's informed consent include the use of diverse samples and control groups, development of multidimensional and standardized measures of competence, utilization of multidimensional and standardized measures of competence, utilization of observational methods and longitudinal designs, examination of noncognitive aspects of children's competence and comparison of children's competence for treatment and research decisions.
本叙述性综述总结了关于儿童在研究和治疗环境中同意和赞成能力的实证文献。研究方法差异很大，特别是在参与者抽样、所研究的情境背景（例如，心理与医疗环境）、使用的程序（例如，基于实验室与现实世界的方法）以及能力测量方面。本综述还确定了儿童知情同意方法背后的几个基本困境。这些困境，包括自主与最佳利益方法、法律与心理或伦理方法、基于儿童与基于家庭的方法，以及强调同意与强调赞成的方法，对儿童能力的测量和研究结果的解释都有影响。关于儿童知情同意领域未来研究的建议包括使用多样化的样本和对照组、开发多维和标准化的能力测量方法、利用观察方法和纵向设计、检查儿童能力的非认知方面，以及比较儿童在治疗和研究决策方面的能力。
