Todres: Children’s Right to Participate has Powerful Implications in Health Care
When children participate in discussions regarding health care options, their health outcomes improve. Yet children are often excluded from having meaningful involvement in health care decisions.
The right to participate has potentially powerful implications for children’s day-to-day lives and for their future as adults—therefore health care providers should develop more child-rights supportive processes to empower youth, said Georgia State University Professor of Law Jonathan Todres, who researches and writes on a range of issues related to children’s rights and well-being.
“Involving children increases the likelihood that they will follow treatment plans,” Todres said. “It also might improve the treatment plan itself, because engaging children more meaningfully makes it more likely that they will open up and share what is happening in their lives.”
International children’s rights law establishes that any child capable of expressing views has the right to be heard on all matters that affect them. Todres and Angela Diaz, professor of pediatrics and director of the Mount Sinai Adolescent Health Center, discuss the value of advocating for those rights in the health care context in “Adolescents’ Right to Participate: Opportunities and Challenges for Health Care Professionals,” published in the Annals of Global Health. Such rights are critical in health care situations, where significant consequences are at stake, Todres said.
The article cites numerous studies which show the merit of child participation in various settings—from school to health care to the juvenile justice system. Involvement can contribute positively to children’s development, enhance self-esteem and confidence, reduce fear, and foster some sense of control over their lives. Conversely, denying children the opportunity to partake in the decision-making process has a negative effect, resulting in children feeling excluded, devalued, ignored, confused and anxious about their future.
Todres and Diaz outline a number of ways in which health care providers can promote adolescents’ right to participate, including ensuring that scheduling an appointment is easy and hassle free; allowing walk-in appointments for clinics that serve at-risk youth; not making insurance and billing matters the first priority in initial meetings; creating an environment that is colorful, well-lit and clean, with messages that support diversity; and explaining the what, why, and the how at each step of the treatment plan. Initial interactions can set the tone for whether adolescents feel their input will be considered in a meaningful way, and so should be considered part of the continuum of care, not just a triage tool for the health care provider, the article asserts.
“We believe that the rights of children and adolescents should be reflected in the entire health care process, from the moment they call to make an appointment, to the built environment where they access care, to the interactions with all staff, including clinicians, to the treatment plan, and finally to any follow-up care,” Todres said.
Creating meaningful opportunities for children to be heard can be difficult, Todres acknowledges. “It requires time, patience, and a commitment to meeting children where they are, as opposed to insisting that children fit into adults’ structures and processes.”
Despite the challenges, health care professionals, who broadly support the idea that we should listen to children, are well positioned to support and enable youth to exercise and enjoy their rights, Todres said.
“Doing so is vital, if we are to ensure positive outcomes and healthy development for all children,” he said.