Research On Children Presents Ethical Dilemmas

Main Category: Pediatrics / Children's Health
Also Included In: Clinical Trials / Drug Trials
Article Date: 30 Aug 2008 - 0:00 PDT

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The thorny issue of conducting medical research on children is one of the most difficult ethical debates in health care today.

In the Pediatric Ethics, Issues, & Commentary column of the July-August 2008 issue of Pediatric Nursing, author Pam Pieper examines two schools of thought regarding this controversial topic. Central to the debate is whether or not a child's assent to participate in research should be mandated, considering that in some cases, the child may be unable or too young to give such assent.

Pieper presents two theories: deontology, an "ethical stance, where one's actions are based on what is morally correct, irrespective of the consequences." This viewpoint states such research is ethical only when it potentially benefits the child and includes the child's consent. The second theory, utilitarianism, focuses on a course of action that results in the greatest good for the greatest number of people. In other words, research that benefits many children but possibly puts a few at risk is justified by the final result. Under this theory, assent is not mandated.

"Children have often been denied the benefits of research advancements because of restrictions against their participation in research," Pieper writes. She adds that some children may choose to participate in research and that there should not be sweeping restrictions that take away their autonomy, especially when others could benefit. Utilitarianism is the more widely accepted perspective, she says, and even when children can't assent, if parental permission and appropriate safeguards are added into the mix, they should still be given the opportunity to participate in studies.

"Ethical Perspectives of Children's Assent for Research Participation: Deontology and Utilitarianism"
Pam Pieper, MSN, ARNP, PNP-BC
Pediatric Nursing, July-August 2008

Pediatric Nursing