What is assent, and when is it appropriate to obtain it?

• A. Assent is a legal consent by guardians; obtained for all patients.
• B. Assent is a child’s affirmative agreement to participate in treatment; obtained when the patient is not fully capable of providing informed consent.
• C. Assent means refusing participation.
• D. Assent is only for adults with mental disabilities.

Answer: (B)

Assent is a child’s affirmative agreement to participate in a treatment or procedure. It is appropriate to obtain assent when the patient is not fully capable of providing legally valid informed consent due to age or developmental status. In pediatrics, the parent or guardian gives the legal consent, but asking for the child’s assent honors the child’s developing autonomy, improves understanding, and supports cooperation. The process uses age-appropriate explanations, describes what will be done, the potential risks and benefits, and invites questions. The child’s assent is sought even when a guardian has already consented; if the child agrees, treatment proceeds with guardian consent, and if the child objects or cannot understand, clinicians explore concerns and consider alternatives while still acting in the child’s best interests. Assent is not a refusal, and it is not used for adults or individuals with mental disabilities.