Miller Victoria A, Nelson Robert M
Center for Research Integrity, The Children's Hospital of Philadelphia, PA 19104, USA.
J Pediatr. 2006 Jul;149(1 Suppl):S25-30. doi: 10.1016/j.jpeds.2006.04.047.
The question of when and how to obtain child assent for nontherapeutic research has received increasing attention in recent years. Although child assent and parent permission are grounded in the principle of respect for persons, assent is often understood from the more narrow principle of respect for autonomy. When viewed in this way, "assent" is frequently conflated with "consent," and children are held to a higher standard than what might be sufficient for meaningful involvement in decision-making about research participation. When nested within the requirement for parental permission, child assent functions as a way to promote children's moral growth and developing autonomy, rather than as an autonomous decision. A developmental approach to child assent is necessary to understand how children can be meaningfully involved in decision-making about research participation across development. This approach suggests that the content and process of child assent should be allowed to vary across development. In addition, a developmental approach requires that future research employ longitudinal designs, examine the developmental mechanisms underlying age variations in child assent, and attend to both cognitive and noncognitive variables that may influence the assent process as children mature.
近年来,关于何时以及如何获得儿童对非治疗性研究的同意这一问题受到了越来越多的关注。尽管儿童同意和家长许可都基于尊重人的原则,但同意通常是从更狭义的尊重自主性原则来理解的。从这个角度看,“同意”常常与“赞同”混为一谈,并且对儿童的要求标准高于让他们有意义地参与研究参与决策可能所需的标准。当包含在家长许可的要求之中时,儿童同意起到促进儿童道德成长和自主性发展的作用,而不是作为一个自主决定。采用发展性方法来对待儿童同意对于理解儿童如何能够在整个成长过程中有意义地参与研究参与决策是必要的。这种方法表明,儿童同意的内容和过程应允许随成长而变化。此外,发展性方法要求未来的研究采用纵向设计,研究儿童同意中年龄差异背后的发展机制,并关注随着儿童成熟可能影响同意过程的认知和非认知变量。