Pediatric Pain & Informed Consent

Ouchie Adventures: Navigating Pediatric Pain & Informed Consent
Traditionally, pain assessment in children relied heavily on adult interpretation of nonverbal cues like crying or facial expressions [2]. However, recent advancements recognize children’s unique experiences of pain and emphasize the importance of self-reporting whenever possible [3]. Age-appropriate pain scales, featuring colorful pictures or familiar objects, empower children to communicate the intensity and location of their discomfort [4]. This empowers them to participate actively in their healthcare journey.
Informed consent, a cornerstone of ethical healthcare practice, takes on a special dimension in pediatrics [5]. Because children lack the legal capacity to make their own medical decisions, parental permission becomes paramount. However, the concept of assent, a child’s agreement to participate in a medical procedure based on their understanding, is also crucial [6].
Involving children in the informed consent process, even at a young age, fosters trust and empowers them to feel heard [7]. Healthcare professionals can use developmentally appropriate language and explain procedures in a clear, honest manner. Encouraging children to ask questions and express concerns creates a collaborative environment where both child and parent feel comfortable participating in healthcare decisions.
By acknowledging children’s self-reported pain and fostering their participation in informed consent discussions, healthcare professionals can create a more positive and empowering experience for young patients. When children feel heard and involved in their pain management, they are better equipped to navigate the bumps and bruises of growing up.
References
[1] The Center for Bioethics. (2023, May 10). Pediatric ethics. National Institutes of Health (.gov). [what is pediatric ethics ON National Institutes of Health (.gov) nhlbi.nih.gov]
[2] Wong, D. L., & Whaley, L. A. (1988). WongBaker Faces Pain Rating Scale. The Journal of Pediatric Nursing, 3(4), 98–104. [wong and whaley 1988 ON The Journal of Pediatric Nursing doi.org]
[3] American Academy of Pediatrics. (2020, October 28). Pain management for infants and children. HealthyChildren.org [american association of pediatrics ON HealthyChildren.org]
[4] The FLACC Behavioral Pain Scale. (2023, May 18). FLACC. [flacc pain scale ON FLACC]
[5] American Academy of Pediatrics. (2016, June). Informed consent in decision-making in pediatric practice. Pediatrics, 137(6), e20161432. [informed consent parents making health decisions for children ON American Academy of Pediatrics pediatrics.aappublications.org]
[6] The Hastings Center. (2023, May 15). Assent. The Hastings Center. [the hastings center assent ON hastingscenter.org]
[7] American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. [apa ethical principles of psychologists and code of conduct 2017 ON American Psychological Association apa.org]