i had this tested on my step1 exam , and was so relieved when i got it right ...am now preparing for my step2 and back to your videos thanks a lot dirty !!!!!
I'm a little torn. UW gives a similar example where a child doesn't want to undergo treatment for recurrent end-stage leukemia. The parents want her to get the treatment. The correct answer is "give the treatment to the patient." Because even though she doesn't want it, her parents are the only ones that need to give consent for the treatment. Edit: your examples are correct, in that both the parents and child must provide consent and assent, respectively. However, for treatment outside the realm of clinical trials (with exceptions,) only the parents need to provide consent. You should get the child on board, but it's not required
I had a question recently: where there was a child with cancer, and he/she didn't want any treatment after the physician had discussed all the options with the family. The parents stated they did want to go through treatment for the child. The answer was: do the treatment for the child. Wouldn't this be a case of child not giving assent, but parents giving consent?
Unless I'm mistaken, informed assent is something more geared towards clinical trials/research rather than broadly across all medical care. It's something that IRBs may require for participation. According to the National Cancer Institute, assent is not required when: "[The] child is not capable of assenting. [The] child might benefit from the treatment or procedure being studied in the trial. The treatment or procedure that may benefit [the] child is only available in clinical trials."
Yeah there is a similar question where the child doesnt want to undergo treatment but the family wants the treatment done and the answer is proceed with the treatment. But i think this would be for treatment in general. If the question pertains to anything regarding experimental trials, then i think that informed assent would be required. If its a question pertaining to medical care in general , then an assent would not be required
Nice! But this is only for clinical trails , in a normal hospital setting if the parents give consent for an aggressive form of treatment like chemo but the child does not agree in full mind after knowing everything, the treatment is done because assent is not required to start treatment after getting consent from the guardian or parent .
so basically... its primarily the autonomy of the minor pt. that needs to be respected, we need the minor's assent. and in addition to that we need the consent of the guardians except in the cases of certain conditions.
Is this only for clinical trials? If not, what is the age where informed assent becomes a thing? On the wards, we had plenty of minor patients under 10 who definitely did not want to get IVs or their chemo because it sucks, but we still did it because they're kids and they're only thinking in the short term.
Consent is not required for things that fall into the "Sex, Drugs and Rock n' Roll" category, as per FA. Consent is also not required in case of life saving procedures for a minor (mother and child, car crash, Jehova Witnesses, father unreachable, transfuse only child and not mother etc). However, as this is a clinical trial with the possibility of treating the disease and not a definitive lifesaving cure, physician cannot perform procedure as legal guardians did not give consent. Assent does not over ride consent, not in the case of your question, not in my understanding at least. But what do I know, I'm just another IMG! Whaddayathink?
This is dependent on your protocol. There are some studies which require verbal assent as early as 7 years of age, other which require written assent starting at age 14. It varies on your protocol.
For EDUCATIONAL purposes only. Not to be used as medical, legal, or other advice!
i had this tested on my step1 exam , and was so relieved when i got it right ...am now preparing for my step2 and back to your videos thanks a lot dirty !!!!!
Ethics series is amazing! Thanks a lot!!!!!. Please post the questions series, its very useful!
Thank You so much for the video. And yes, please keep those question series coming. They're very helpful!
I'm a little torn. UW gives a similar example where a child doesn't want to undergo treatment for recurrent end-stage leukemia. The parents want her to get the treatment. The correct answer is "give the treatment to the patient." Because even though she doesn't want it, her parents are the only ones that need to give consent for the treatment.
Edit: your examples are correct, in that both the parents and child must provide consent and assent, respectively. However, for treatment outside the realm of clinical trials (with exceptions,) only the parents need to provide consent. You should get the child on board, but it's not required
is that for any age below 18??
OMGGGGG
I had a question recently: where there was a child with cancer, and he/she didn't want any treatment after the physician had discussed all the options with the family. The parents stated they did want to go through treatment for the child. The answer was: do the treatment for the child. Wouldn't this be a case of child not giving assent, but parents giving consent?
Where did you come across this question?
Yaa i got similar question in Uworld. They said you have to inform child but their decision does not affect what parents will consent for.
Unless I'm mistaken, informed assent is something more geared towards clinical trials/research rather than broadly across all medical care. It's something that IRBs may require for participation. According to the National Cancer Institute, assent is not required when:
"[The] child is not capable of assenting.
[The] child might benefit from the treatment or procedure being studied in the trial.
The treatment or procedure that may benefit [the] child is only available in clinical trials."
Yeah there is a similar question where the child doesnt want to undergo treatment but the family wants the treatment done and the answer is proceed with the treatment. But i think this would be for treatment in general.
If the question pertains to anything regarding experimental trials, then i think that informed assent would be required. If its a question pertaining to medical care in general , then an assent would not be required
@@WillQuach I'm still confused. Where did you read it?
Thank you very much! Can you please explain the only unique situation when consulting the ethics committee is actually correct answer?
Always pick your first option
Dirty- you are the best, exact question on boards! Great mnemonics helped a lot!!
Regarding what is high yield for step one, Dirty is Class 1A type of evidence. Period.
Nice! But this is only for clinical trails , in a normal hospital setting if the parents give consent for an aggressive form of treatment like chemo but the child does not agree in full mind after knowing everything, the treatment is done because assent is not required to start treatment after getting consent from the guardian or parent .
I'm still confused. Where did you read it?
Earlier ethics and communication skills were too difficult for me,thank u so much for these wonderful videos....kudos to ur hardwork...!
For the last question in the vid, why don't we direct the informed assent process based on IQ (esp if a minor patient may be intellectually impaired)?
so basically... its primarily the autonomy of the minor pt. that needs to be respected, we need the minor's assent. and in addition to that we need the consent of the guardians except in the cases of certain conditions.
Marvellous
Is this only for clinical trials? If not, what is the age where informed assent becomes a thing? On the wards, we had plenty of minor patients under 10 who definitely did not want to get IVs or their chemo because it sucks, but we still did it because they're kids and they're only thinking in the short term.
What if the parents didn’t consent for the procedure , for example, but the patient gave her informed assent? What should be done in this case?
then it shouldn't push through, I guess
Nicole Faye Sacay I guess that’s the case
Consent is not required for things that fall into the "Sex, Drugs and Rock n' Roll" category, as per FA. Consent is also not required in case of life saving procedures for a minor (mother and child, car crash, Jehova Witnesses, father unreachable, transfuse only child and not mother etc). However, as this is a clinical trial with the possibility of treating the disease and not a definitive lifesaving cure, physician cannot perform procedure as legal guardians did not give consent. Assent does not over ride consent, not in the case of your question, not in my understanding at least. But what do I know, I'm just another IMG! Whaddayathink?
@@mohammedbhaimbbs8602 You are correct. For the purposes of a clinical trial, informed consent authorization from a legal guardian is required.
Thanks a lot
Thanks!
What's about minor want to participate but parents don't?
Thank you.
For the purpose of a clinical trial, informed consent is required from a legal guardian for most minors EXCEPT for emancipated minors.
Is there a lowest age limit?? Like,can a four year old refuse? Can the parents of a two year old give consent and proceed straightaway??
This is dependent on your protocol. I have not had a study which required assent from a participant less than 7 years of age.
tnx alot
here❤
starting at what age, shall we take assent from the minors?
This is dependent on your protocol. There are some studies which require verbal assent as early as 7 years of age, other which require written assent starting at age 14. It varies on your protocol.