Informed consent and minors

The provision of informed consent by a patient should be the end point of a process of engagement in which one or more health practitioners have supported the patient to come to an informed decision to agree to the healthcare offered. Informed consent is a means to comply with the principle of respect for the person in a healthcare context. Respect for the person implies a special care and not, indifference, so that consent implies the due engagement of the person in the decision process as the very etymology of the word consent suggests. As for minors, the Oviedo convention prefers to use the word authorisation instead of the common expression consent on behalf of the child. In fact, authorisation relates to the concept of a third authority, such as parental responsibility, which implies a different framework than that of informed consent. This is the concept of the child's best interests as the fundamental criterion of making decisions regarding children. Moreover, the Oviedo convention requires that the opinion of the minor shall be taken into consideration. As a result, the decision-making process involves three categories of subjects: the physician who proposes the therapy, the parents who give authorisation and the minor whose opinion “is an increasingly determining factor in proportion of his or her degree of maturity”.