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Keywords:

  • children’s rights;
  • consent;
  • autonomy;
  • competence;
  • United Kingdom;
  • health care;
  • treatment;
  • ethics;
  • law

Children’s rights: a decade of dispute

Aim. This paper attempts to raise issues surrounding children’s rights against a backdrop of ethical principles and their subsequent interpretation and application in practice.

Method. Key words have been used to search a selection of electronic databases and a range of ‘grey’ literature has been reviewed.

Background. Over a decade ago the United Nations (1989) Convention on the Rights of the Child was ratified, with the exception of two member states (UNICEF 2000). The Human Rights Act (Department of Health 1998) became law in October 2000 in the United Kingdom (UK). Despite a decade of recommendations, guidelines and legislation, children’s rights, particularly consent to health care, remain complex and inconsistent. As we move into a new era of human rights involving all members of society, it is timely for nurses in the UK to reflect on the challenges created in attempting to interpret the philosophy of such legislation because such complexity surrounds the interpretation of human rights for many other vulnerable clients within health care.

Findings. The interpretation of children’s rights continues to be influenced by the evolution of the meanings of childhood. Adults view children’s rights from multiple perspectives of best interest, which are determined by their beliefs about children’s ability to understand and consent to health care and treatment. An ability and right to consent appears not to be balanced by the right to withhold consent. Inconsistency and ambiguity persist in the law and its interpretation. Adults need to develop a more pragmatic approach to children’s rights. This requires better understanding of children and their experiences of health care.

Conclusion. Until adults develop a more pragmatic ideology in relation to children’s rights then a true respect for children’s autonomy will not be achieved. Consent will therefore remain an adult and legal prerogative.