Rights of children in pediatric settings: a survey of attitudes.

This study compares the attitudes of parents and health care professionals toward the bill of rights for children in pediatric settings of the National Association of Children’s Hospitals and Related Institutions (NACHRI) and a locally developed ombudsman committee bill of rights. Parents (N = 64), attending physicians (N = 33), resident physicians (N = 17), nurses (N = 27), nonmedical professionals (N = 35), administrators (N = 18), and clerical workers (N = 17) were surveyed. Each person rated statements derived from the bills from “strongly agree” to “strongly disagree.” Analyses of variance indicated a high level of agreement overall for both bills by all groups; however, the local bill was significantly preferred. There were significant differences in agreement between the groups for the local bill and the two bills combined (an overall measure of attitudes about children’s rights in pediatnc settings). Attending physicians tended to agree significantly less than other groups. On the 32 individual items, attending or. resident physicians were significantly lower in iigreem#{232}nt than most other groups on 11 items, and nurses were lowest on one other. Disagreement was strongest on items concerning abortion or confraception, the child’s right to privacy, the right to consent to care, and the right to have an immediate response from the physician in understandable language. Pediatrics 60:715-720, 1977, CHILDREN’S RIGHTS, PROFESSIONALS’ ATflTUDES. Throughout most of history the rights of children have been either denied, ignored, or subOrdinated to their economic or filial duties.1 In Roman law, “fathers had absolute power over their children, including the right to decide on matters of life or death and slavery or freedom.”2 Under English common law, fathers exercised the utmost authority over their legitimate minor children. While having a duty to support and protect them, this obligation was not legally e#{241}f#{244}rceable.2 In the present century, awareness has increased that children have special needs and must be extended certain rights if they are to be afforded an opportunity for optimal development. Several manifestations of this trend are apparent. Increasingly, the courts are being used to resolve conflicts between the rights of children and the rights, responsibilities, and actions of their parents.2 This is best noted in the development of child abuse legislation throughout the United States. Second, various state and national commissions have recognized that no single group or agency effectively advocates for the needs and rights of children.3 Such organizations have urged the development f child advocacy commissions to defend the needs and rights of children, both individually and collectively. Finally, there has been a proliferation of bills of rights for children developed by national commissions and study groups. These bills46 serve as statements of pmciple recognizing the developmental needs of children. Bills of rights have been developed for children in general46 as well as for groups of special, handicapped children.78 There has been speculation that asserting and implementing the rights of children will be met with varying degrees of acceptance and resistance.9 Because of the implications that the assertion of children’s rights may, have for public policy, a wide disparity in attitudes is highly likely: “We believe that every American child has the right to a mentally healthy life of well-being and effectiveness. If we are to fulfill this right, we must face squarely the social crises of our times and commit ourselves to radical social change [italics added}.”#{176} Attitudes toward the rights of children may Received February 2; revision accepted for publication June 29, 1977. ADDRESS FOR REPRINTS: (J.V.L.) Children’s Memorial Hospital, Medical Psychology, 2300 Children’s Plaza, Chicago, IL 60614. by guest on January 22, 2018 http://pediatrics.aappublications.org/ Downloaded from