What makes a child a ‘competent’ child?
Amanda van Rooyen, Tineke Water, Shayne Rasmussen, Kate Diesfeld
To give informed consent to healthcare in New Zealand, competence is a requirement. A person needs to understand the nature, purpose and consequences of treatment and non-treatment in order to give a legally valid agreement to healthcare. However, New Zealand law is unclear on this matter where children are concerned. Although not overtly stated, New Zealand law infers that children under the age of 16 years may give or withhold consent to healthcare, independent of their parents, so long as they are competent to do so. This article raises the questions; what is child competence, why is it so important to acknowledge and how do healthcare professionals assess for child competence? Unfortunately, there is meagre research in this area and no clear answers. The assessment, recognition and respect for a childs level of competence not only supports ethical arguments regarding respect for their rights and personhood; it has other more tangible benefits to both the child and healthcare services. These include improved treatment adherence, clinical effectiveness, health service delivery and disease prevention. Therefore, this article addresses how these benefits can be realised through a better understanding and assessment of childrens abilities to participate in and consent to healthcare.