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A 10-year-old boy received a diagnosis of osteosarcoma a year ago, and his treatment regimen is no longer effective. The oncology team discusses different treatment plans, including enrollment in phase I trials, and during the conversation, his parents ask the patient if he thinks the benefit of such a trial would outweigh the potential burdens. The patient communicates that he believes there would be benefit and he would like to enroll in the trial. Which concept is being demonstrated in this scenario?

A. The patient is giving informed consent to participating in the trial.

B. The patient is giving assent to participating in the trial.

C. The medical team is providing assent to the patient’s participation in the trial.

D. The parents are serving in the role of guardian ad litem and allowing the patient to consent to the trial.

E. The meeting has resulted in collective consent for the clinical trial.

Answer: B

Minors, defined as persons under the age of 18, typically do not have legal authority to provide consent to medical treatments, although this varies by state and type of medical treatment. The mature minor doctrine may allow children as young as 13 years to provide consent if able to demonstrate understanding, but in this case, the child is 10 years old. This decision-making process represents the team and family seeking the child’s assent to participating in the trial.

A newborn is found to have sickle cell disease (HbSS) on routine screening. His father asks when, and to what detail, he should eventually tell his son about his medical condition as he gets older. How should you respond?

A. When the child turns 4 years old, an appointment can be set to meet with a child life specialist to help him understand his condition.

B. Discussions about his medical condition should start with the appearance of disease progression or his first hospitalization.

C. Prior to him starting elementary school, conversations about his condition should be limited to him simply knowing that he is sick but there are effective treatments.

D. Discussions vary from child to child based on intellectual development, and a child’s own questions can serve as a guide.

E. Initial reading lessons should include basic medical information so as to normalize future conversations about his medical condition.

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