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Children as partners with adults in their medical care
Aims: To investigate the seldom published views of children with type 1 diabetes about their condition and ways in which they share in managing their medical and health care with adults.
Methods: Semi-structured, tape recorded interviews, during 2003, with a purposive sample of 24 children aged 3ā12 years who have type I diabetes and who attend two inner London hospitals and one hospital in a commuter town.
Results: The children reported high levels of understanding, knowledge, and skill gained from their experience of living with diabetes and constantly having to take account of the condition and their paediatricianās guidance. Their key goals were to be ānormalā and ājust get on with their livesā.
Discussion: The interviews showed that childrenās experiences of diabetes tended to enable them to make informed, āwiseā decisions in their own best interests, even at a young age. They achieved a complicated balance between the sometimes competing goals of social health ābeing normalā and physiological health in controlling glycaemia. Their competence supports approaches in childrenās rights and in policy makersā aims that people with diabetesāincluding childrenāgain more knowledge, skills, and responsibility for their own care in partnership with healthcare professionals. Consent is usually considered in relation to surgery; however the children showed how they constantly dealt with decisions about consent or refusal, compliance with, or resistance to their prescribed treatment. Their health depends on their informed commitment to medical guidance; more research is needed about the daily realities of childrenās committed and responsible co-management of their chronic illness
Review essay: justice, rights, agency and childhood research.
The three books in this review are very different, but they illuminate one another in sharing strong themes of justice, rights and agency. Two books by lawyers on justice and mercy and on liberty and equality are linked to a book by a sociologist on children and agency. The review considers how practitioners, policy makers and researchers can work together to promote childrenās rights to justice and liberty
International human rights, citizenship education, and critical realism
Citizenship education invokes dilemmas even for the most committed teachers and students, researchers, and innovators. How can citizenship education advance equity and equal rights within highly unequal schools and societies? How can it support young people to feel they have the competence, confidence, and right to vote and to challenge injustice? How can we be sure international human rights are realities, not merely passing ideologies? This paper argues that rights really exist as expressions of visceral embodied human needs and moral desires that are integral to human relationships. Rights also serve as powerful legal structures that can help to prevent and remedy wrongs, and they work as enduring high standards and aspirations. The paper suggests how critical realism can help educators to resolve dilemmas in theoretical education about rights as knowledge, principles, and mechanisms, and in practical education that enables students to enjoy and exercise their rights and respect those of other people
Informed consent: ideal or reality?
Is it ever possible to give informed consent to treatment or research? Are the standards of consent set by ethicists and lawyers too high for ordinary people to reach? Should these standards be abandoned or modified? These questions are discussed in this paper mainly in relation to the extensive literature on consent in medicine, with examples about consent to children's treatment and research which raise extra dilemmas. Paradoxical meanings are considered: consent as an informed correct choice or a courageous best guess, and autonomy as isolated, uncompromised freedom or reasonably uncoerced self-realisation. Beyond being informed, consent involves evaluating, making and signifying a decision. It is better understood as a process than an event, in which reasoned understandings can be complemented by emotional insights. Ethical and legal standards of voluntary consent, although partly an unrealistic ideal, provide important guidelines for people who request and give consent to research
Review of Young and Free: [Post]colonial Ontologies of Childhood, Memory and History in Australia, written by Joanne Faulkner
The lost and stolen child is seen as central to colonial and [post]colonial Australian in Young and Free. Colonialist-settlers continue in their efforts to modernise the Aboriginal people by imposing their imagined ideas of proper childhood on indigenous children, the age group most easily colonised and subdued. To the colonialists-settlers, the native children were innocent and impressionable blank slates, to be recruited into projects to control and manage their knowledge in boarding schools, orphanages or as slaves in settler households. Similar policies now displace refugee children seeking asylum in Australia out to offshore detention centres. Joanne Faulkner traces how childhood has been a symptom of the state of the nationās drifting consciousness and the site of memory and also of forgetting and of the unconscious
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