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  1.  35
    Why is It Hard to Make Progress in Assessing Children’s Decision-Making Competence?Irma M. Hein, Pieter W. Troost, Alice Broersma, Martine C. De Vries, Joost G. Daams & Ramón J. L. Lindauer - 2015 - BMC Medical Ethics 16 (1):1.
    For decades, the discussion on children’s competence to consent to medical issues has concentrated around normative concerns, with little progress in clinical practices. Decision-making competence is an important condition in the informed consent model. In pediatrics, clinicians need to strike a proper balance in order to both protect children’s interests when they are not fully able to do so themselves and to respect their autonomy when they are. Children’s competence to consent, however, is currently not assessed in a standardized way. (...)
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  2.  96
    Informed Consent Instead of Assent is Appropriate in Children From the Age of Twelve: Policy Implications of New Findings on Children’s Competence to Consent to Clinical Research.Irma M. Hein, Martine C. De Vries, Pieter W. Troost, Gerben Meynen, Johannes B. Van Goudoever & Ramón J. L. Lindauer - 2015 - BMC Medical Ethics 16 (1):1-7.
    BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...)
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  3.  20
    Key Factors in Children’s Competence to Consent to Clinical Research.Irma M. Hein, Pieter W. Troost, Robert Lindeboom, Marc A. Benninga, C. Michel Zwaan, Johannes B. van Goudoever & Ramón J. L. Lindauer - 2015 - BMC Medical Ethics 16 (1):74.
    Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.
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