What is the appropriate approach to obtaining assent from a pediatric patient?

• A. Assent from the child when they are capable, in addition to parental consent
• B. Assent is not needed if parents consent
• C. Assent should replace parental consent
• D. Assent is only for teenagers above 16

Answer: (A)

Respecting a child’s developing autonomy is essential in pediatric care. Obtain assent from the child when they are capable, in addition to obtaining consent from a parent or guardian. Assent means explaining the plan of care in language appropriate to the child’s age and understanding, checking that they grasp what will happen, and obtaining their voluntary agreement to participate. It is not a substitute for parental consent; parents remain the legal decision-makers and must authorize the care. Involving the child through assent helps reduce fear, builds trust, and respects the child’s preferences. If a child cannot assent or refuses, proceed with the parent's consent while addressing the child’s concerns and involving them as much as possible within the clinical context.