SPOTLIGHT ARTICLES – YOUNG PERSONS

For our Spotlight section this month, we feature our full Young Persons section, recognizing that the articles included are both important and diverse.

We note in particular, two recent review articles discussed further just below, as well as a position statement from the Malaysian Academy of Medicine for obtaining assent for research involving children in that country, with an interesting set of recommendations. These recommendations include enhancing comprehension, by “…customising assent procedures by integrating visual aids, multimedia resources, verbal explanations and open question sessions. Innovative methods, such as combining images with text or utilising multimedia…” to help “ensure the development of its best practice.”

In the Journal of Adolescent Health article Positive Impacts of Adolescent Involvement in Health Research: An Umbrella Review, Warraitch et al. present the positive impact experienced by adolescents when included in research, as well as the resulting increased quality of the research involved. In their Conclusion, the authors argue that “…Moving forward, rigorous evaluation of adolescent involvement and transparent reporting methods are vital to advancing our understanding of the benefits of engaging youth. By recognizing the transformative potential of adolescent engagement, this review calls for proactive efforts from researchers, institutions, and funding agencies to promote and sustain their active involvement in research initiatives.”

In the AJOB Empirical Bioethics article Pediatric Assent in Clinical Practice: A Critical Scoping Review Wasserman et al. lay out the contextual elements unique to pediatric assent, including its long-term development, and how to approach unique ethical elements involved, such as respect, empowerment and rights. The authors underscore three central themes emerging from their analysis:
[1] Valid pediatric assent depends on the context. It varies by treatment and geographic/cultural setting.
[2] Pediatric assent is conceived as a longitudinal process in two distinct ways. One involves mul­tiple iterations of eliciting the preferences of pediatric patients within the context of a treat­ment decision or episode of care; the other involves attending to children’s developmental maturity over time.
[3] The ethical justifications for pediatric assent are underspecified. Authors often invoked ambigu­ous notions like “respect” or drew heavily on the concept of autonomy, despite its question­able relevance in many pediatrics cases.