Assent and Dissent in Pediatric Progressive and Critical Care

Not long ago, medical decisions were made exclusively by physicians with the philosophy that “doctor knows best.” This thinking has evolved over time, as the current evidence-based literature supports a model of decision making in which health care providers engage in collaborative partnerships with patients and families. Unfortunately, strategies for communicating with pediatric patients may be a neglected part of health care provider education.²  A lack of this important competency may be a barrier to building trusting partnerships with patients admitted to pediatric progressive and critical care units and their families. Intentional skill building in pediatric communication is vital, so that children feel comfortable in the care of the providers.^2,3  Although evidence supports collaborative partnerships between pediatric patients and health care professionals, some providers and pediatric researchers still think that it is best not to engage children in the assent process, as assent is nonbinding and...