In pediatric perioperative care, who provides consent and when is assent appropriate?

• A. Parent/guardian provides consent; child assent should be obtained when appropriate; consent must be voluntary and informed.
• B. Consent is provided by the child alone.
• C. Consent is not required for pediatric procedures.
• D. Only physician can provide consent.

Answer: (A)

In pediatric perioperative care, the person who gives consent is the parent or legal guardian after they’ve been fully informed about the procedure, its risks and benefits, alternatives, and what could happen if it’s not done. The minor does not have legal authority to consent, but we should involve the child by seeking assent when developmentally appropriate. Assent means the child’s affirmative agreement to participate, presented in an understandable way and without pressure, and it respects the child’s growing autonomy. The actual consent must be voluntary and informed, with a clear opportunity to ask questions, and it should occur before any surgery or anesthesia is performed. The clinician who discusses the plan—often the physician, but any appropriately delegated clinician under the physician’s oversight—can obtain consent, but the legal responsibility rests with the parent or guardian.