Who should decide about children’s and adolescents’ participation in health research? The views of children and adults in rural Kenya

BMC Medical Ethics 20 (1):41 (2019)
  Copy   BIBTEX

Abstract

International research guidance has shifted towards an increasingly proactive inclusion of children and adolescents in health research in recognition of the need for more evidence-based treatment. Strong calls have been made for the active involvement of children and adolescents in developing research proposals and policies, including in decision-making about research participation. Much evidence and debate on this topic has focused on high-income settings, while the greatest health burdens and research gaps occur in low-middle income countries, highlighting the need to take account of voices from more diverse contexts. Between January and March 2014, 56 community representatives and secondary school students were involved in eight group discussions to explore views on the acceptability of involving children and adolescents in research, and how these groups should be involved in decision-making about their own participation. Discussions were voice-recorded and transcriptions analyzed using Framework Analysis, combining deductive and inductive approaches. Across these discussions, the idea of involving children and adolescents in decision-making about research participation was strongly supported given similar levels of responsibility carried in everyday life; existing capacity that should be recognized; the opportunity for learning involved; varying levels of parental control; and generational shifts towards greater understanding of science for adolescents than their parents. Joint decision-making processes were supported for older children and adolescents, with parental control influenced by perceptions of the risks involved in participation. Moves towards more active involvement of children and adolescents in planning studies and in making decisions about their participation are supported by these findings from Kenya. Important emerging considerations include the need to take account of the nature of proposed studies and prevailing attitudes and understanding of research in identifying children’s and adolescents’ roles. More research is needed to expand diversity and develop approaches to joint assent and consent processes that would fairly represent children’s and adolescents’ wishes and interests, towards their long term benefit.

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 91,202

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Genetic research, adolescents, and informed consent.Robert F. Weir & Jay R. Horton - 1995 - Theoretical Medicine and Bioethics 16 (4).
Adolescent Parents and Medical Decision-Making.K. de Ville - 1997 - Journal of Medicine and Philosophy 22 (3):253-270.
Parents, Adolescents, and Consent for Research Participation.A. S. Iltis - 2013 - Journal of Medicine and Philosophy 38 (3):332-346.

Analytics

Added to PP
2019-06-15

Downloads
27 (#557,528)

6 months
6 (#431,022)

Historical graph of downloads
How can I increase my downloads?

Author's Profile

Alun Davies
University of East Anglia