BackgroundCurrent guidelines do not clearly outline when assent should be attained from paediatric research participants, nor do they detail the necessary elements of the assent process. This stems from the fact that the fundamental justification behind the concept of assent is misunderstood. In this paper, we critically assess three widespread ethical arguments used for assent: children’s rights, the best interests of the child, and respect for a child’s developing autonomy. We then outline a newly-developed two-fold justification for the assent process: (...) respect for the parent’s pedagogical role in teaching their child to become an autonomous being and respect for the child’s moral worth.DiscussionWe argue that the ethical grounding for the involvement of young children in medical decision-making does not stem from children’s rights, the principle of best interests, or respect for developing autonomy. An alternative strategy is to examine the original motivation to engage with the child. In paediatric settings there are two obligations on the researcher: an obligation to the parents who are responsible for determining when and under what circumstances the child develops his capacity for autonomy and reasoning, and an obligation to the child himself. There is an important distinction between respecting a decision and encouraging a decision. This paper illustrates that the process of assent is an important way in which respect for the child as an individual can be demonstrated, however, the value lies not in the child’s response but the fact that his views were solicited in the first place.SummaryThis paper demonstrates that the common justifications for the process of assent are incomplete. Assent should be understood as playing a pedagogical role for the child, helping to teach him how specific decisions are made and therefore helping him to become a better decision-maker. How the researcher engages with the child supports his obligation to the child’s parents, yet why the researcher engages with the child stems from the child’s moral worth. Treating a child as having moral worth need not mean doing what they say but it may mean listening, considering, engaging or involving them in the decision. (shrink)

Beschäftigt man sich systematisch mit der Konzeption von Gerechtigkeit für Kinder bzw. während der Kindheit, ist es hilfreich, drei verschiedene Fragen zu klären, die normalerweise in Hinblick auf Erwachsene diskutiert werden, doch auch für eine genauere Analyse der Ansprüche von Kindern relevant sind. Welche Güter sind für die Gerechtigkeitstheorie relevant? Nach welchen Prinzipien sollen diese Güter verteilt werden? Wer ist dafür verantwortlich, dass die angestrebte Güterverteilung verwirklicht wird? In dieser Einleitung umreißen wir kurz den gegenwärtigen Diskussionsstand, der in diesen drei (...) großen gerechtigkeitsrelevanten Themenfeldern hinsichtlich von Kindern besteht. Zunächst analysieren wir Ressourcen und Fähigkeiten als angemessene Metrik der Gerechtigkeit für Kinder. Hinsichtlich der Verteilungsprinzipien lassen sich vor allem egalitäre und suffizienztheoretische Herangehensweisen unterscheiden. Schließlich werden in Bezug auf die Frage nach den relevanten „Akteuren der Gerechtigkeit“ für Kinder hauptsächlich die Familie bzw. die Eltern und der Staat diskutiert. (shrink)

Child poverty is one of the biggest challenges of today, harming millions of children. In this book, it is investigated from a philosophical social justice perspective, primarily in the context of modern welfare states. Based on both normative theory (particularly the capability approach) and empirical evidence, the authors identify the injustices of child poverty, showing how it negatively affects the well-being of children as well as their whole life course. But child poverty is not 'given by nature'. It is avoidable (...) and there is certainly the moral duty to alleviate it. Therefore, Graf and Schweiger develop a normative theory of responsibilities, which clarifies the moral role of different agents in the poor child's environment: the family, the state and many others, that have so far been neglected in philosophical theories. They conclude their book by sketching how their theory can be extended to global child poverty and what it means to show equal respect and concern for every child - no matter where and in which context they were born. (shrink)

The “new sociology of childhood” replaces the historical notion of children as inherently vulnerable, helpless and in need of protection, with a perception of children as capable of competent, autonomous, social participation. Although this new sociological perception underlies current children's rights literature, Canadian common law, and important Canadian pediatric health care guidelines, children's autonomy in health care contexts remains easily denied or subverted in favour of adult conceptions of their best interests. In order to try to understand why, I use (...) a feminist, relational approach to autonomy to analyze how oppressive social forces might hinder children from developing and exercising their autonomy in health care, and uncover a tendency to silence the voice of the child within bioethical discourse. These results suggest that greater levels of pediatric autonomy could be fostered by overcoming oppressive social forces and by fostering the skills necessary for the development and exercise of autonomy. (shrink)

Obesity and poverty in childhood are widely studied phenomena and despite mixed results, some findings are without doubt: they come with various experiences of mental, physical and social harm, have therefore negative effects on the well-being of children, and they intersect in relation with race, class and gender. In this contribution we analyze child obesity and poverty from a philosophical social justice perspective, which has, to a large extent, so far neglected this topic. We show how they compromise social justice (...) and argue that there is an obligation to implement structural changes to assist the affected children and their families. However, we make also clear that such interventions must not happen in accordance to the current neoliberal fitness and health ideology and its related narrow individualism. (shrink)