Informed consent in pediatric gastrointestinal endoscopy

Abstract

Informed consent has become a major, but also mandatory component in medical praxis nowadays. A great number of forums and publications emphasize its ethical and psychological commands, the most adequate way to obtain it and especially its legal implications. In pediatrics, the implications of this procedure are complex, sometimes confusing or not well understood. Thus, in clinical consultations or simple medical acts, the consent could be seen as implicit; when we talk about maneuvers that lead to psychological or physical discomfort, invasive investigations, including endoscopy or therapeutic acts with possible risks or complications, informed consent from parents or legal tutors, respectively an intellectually, psychologically and socially evolved, educated child’s consent (acceptance) becomes mandatory. We must, however, clarify the nuances between consent and acceptance, not only from the semantic point of view, the proportion of either of the two terms in the final decision, the minor patient’s ability to discern at different age stages and finally the role and the importance of the doctor in such decision makings.