Find out what's happening in the world as it unfolds. More Videos Screen time for children younger than 2 more than doubles, study finds Parents who read to their child on a tablet, whether or not the digital book is interactive, had less social reciprocity -- that is, give-and-take social interaction -- than when they read a traditional book, according to findings published Monday in JAMA Pediatrics.
Researchers from the University of Michigan recorded 37 parent-child duos in a lab set up to look like a living room. Mothers and fathers would read aloud one print book, one tablet book and one interactive tablet book in a minute period to their 2- to 3-year-old children. When parents read digital books, researchers noted that children were much more likely to interrupt the session, obstructing their parents' view of the tablet so they couldn't read it, closing out of the e-book app or grabbing the tablet from their parents. In response, parents were more likely to control their children while reading from a tablet.
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Random House, Inc. Parental consent is not necessary for treatment to go ahead if a young person has consented to it. However, it is considered good practice to try to involve parents in the decision-making process General Medical Council, If a competent young person decides to refuse a treatment that it has been deemed to be in their best interests to have, the issue is more complicated than it is in the case of a child.
Case law supports the argument that, although the young person may be competent, they remain a minor and their refusal may be overruled either by:. If they are confronted with a case in which a competent young person refuses treatment that is considered to be in their best interests, health professionals should seek legal advice. It is worth noting that, although much of the Mental Capacity Act including the presumption of capacity applies to young people, there are some exceptions that are directly relevant to end-of-life care.
For example, neither a lasting power of attorney LPA nor an advance decision to refuse treatment ADRT can be set up by someone under the age of 18 years of age. When it comes to end-of-life care, it is hoped there will be time and opportunity for parents, health professionals and the child or young person if applicable to work together to reach a consensus on what interventions and treatments should or should not take place.
Sometimes, however, disagreements may arise and, even though court declarations can be completed as a matter of urgency, in some emergency situations there may be no time even for this. In these circumstances, treatment may have to be given without consent according to the overriding principle of best interests British Medical Association, The BMA has provided useful guidance regarding parental responsibility and it is important that nurses and other health professionals understand the principles of this as it relates to healthcare.
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The law relating to possession of parental responsibility changed at the beginning of the 21st century. There is specific guidance for:. In Scotland, a father has parental responsibility if he is married to the mother when the child is conceived, or marries her at any point afterwards. Parental responsibility is not lost and cannot be surrendered if the parents divorce or separate — even if the parent no longer has custody or any form of contact with the child.
When a child is adopted, the adoptive parents will automatically have parental responsibility. Those who have parental responsibility may delegate it to others, for example, a carer. Parental responsibility can also be delegated to a court-appointed guardian. If the child is subject to a supervision or care order, parental responsibility can be assumed by a local authority, possibly in collaboration with someone else who has parental responsibility. If the child is born as the result of surrogacy, parental responsibility will rest with the biological mother and her husband if she is married, until the child is either adopted by the intended parents or parental responsibility is conferred to them by a court order.
Although older children and young people may be competent to make decisions about their care, in which case they should be actively involved in decision making, this may not be the case for their younger counterparts. Although the views and preferences of children deemed not competent to make the decision about treatment should be sought and considered as part of the decision-making process, ultimately it will be someone with parental responsibility who will consent to, or refuse, treatment. Box 4 sums up the key legal points regarding decision making for children and young people, which apply to end-of-life care and to healthcare decision making more widely.
Box 4. Decision making for the care of children and young people: key legal points. Sign in or Register a new account to join the discussion. You are here: End of Life and Palliative Care.
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Legal issues in end-of-life care 2: children and young people. Abstract When a child or young person is near the end of life, who makes decisions about their treatment?