Parents' consent to neonatal decisions about feeding and discharge

English law requires health care practitioners to obtain parents' consent before all touching of their child. However, nurses tend to leave doctors to request parents' consent to intensive care interventions, and it is generally assumed that before parents can start to care for their baby, they need to have practitioners', mainly nurses', permission. This paper reviews examples of neonatal feeding and discharge decisions that illustrate how consent can be an undeveloped concept in nursing care. Through the sharing of information and medical decision making, the consent process involves implicit or explicit negotiation of anxiety, trust and risk. Decisions about neonatal feeding and discharge can also involve anxiety and risk, and it is suggested that, while avoiding legalistic formalities, more overt sharing of information and decisions about the options could be to the advantage of nurses, babies and parents. © 2005 Neonatal Nurses Association

Competent children?: minors’ consent to health care treatment and research

This paper concentrates on controversies about children's consent, and reviews how children's changing status as competent decision makers about healthcare and research has gradually gained greater respect. Criteria for competence have moved from age towards individual children's experience and understanding. Uncertain and shifting concepts of competence and its identification with adulthood and childhood are examined, together with levels of decision-making and models for assessing children's competence. Risks and uncertainties, methods of calculating the frequency and severity of risks, the concept of 'therapeutic research' and problems of expanding consent beyond its remit are considered. The paper ends by considering how strengths and limitations in children's status and capacities to consent can be mirrored in researchers' and practitioners' own status and capacities. Examples are drawn from empirical research studies about decision-making in healthcare and research involving children in the UK

Institutional rites and rights: a century of childhood

Over the past century in Britain, adults' rights have completely changed so that, at least in theory, all adults are respected choice-makers and not submissive dependents

Down's Syndrome: cost, quality and value of life

Routine prenatal screening is based on the assumption that it is reasonable for prospective parents to choose to prevent a life with Down's syndrome. This paper questions whether Down's syndrome necessarily involves the costs, limitations and suffering which are assumed in the prenatal literature, and examines the lack of evidence about the value and quality of life with Down's syndrome. Tensions between the aims of prenatal screening policies to support women's personal choices, prevent distress, and reduce the suffering and costs of disability, versus the inadvertent effects of screening which can undermine these aims, are considered. Strengths and weaknesses in medically and socially based models of research about disability, and their validity and reliability are reviewed. From exploratory qualitative research with 40 adults who have congenital conditions which are tested for prenatally, interviews with five adults with Down's syndrome are reported. Interviewees discuss their relationships, education and employment, leisure interests, hopes, aspects of themselves and of society they would like to change, and their views on prenatal screening. They show how some people with Down's syndrome live creative, rewarding and fairly independent lives, and are not inevitably non-contributing dependents. Like the other 35 interviewees, they illustrate the importance of social supports, and their problems with excluding attitudes and barriers. Much more social research with people who have congenital conditions is required, if prenatal screening policies and counselling are to be evidence based

Nurse Practitioners\u27 Characteristics and Job Satisfaction

PURPOSE: To identify demographics and job satisfaction levels of currently working nurse practitioners (NPs) in California. DATA SOURCES: A mail-in survey was used to gather data The Mueller McCloskey Satisfaction Scale was sent to a randomized sample of 200 California NPs with active licensure. Descriptive statistical analysis of usable data was employed. CONCLUSIONS: NPs reported high levels of job satisfaction. Aspects of the job that showed significant levels of satisfaction were schedules, flexibility of hours, and interprofessional relationships. NPs were least satisfied with not having professional opportunities such as participation in nursing research, writing/publishing, and belonging to a department/nursing committee

Trends in research about health in early childhood: economics and equity, from micro-studies to big business

Research about health is concerned with physical and mental well-being, illness and injury. Directly or indirectly, health relates to almost every aspect of early childhood. This article reviews the enormous range of research available, examining the aims and purposes of the studies, their methods and findings and the ways in which childhood and child-adult relationships are conceptualized. In particular, this article is concerned with whether the evidence available arises from studies concerned with cost-effectiveness or with equity and the re-distribution of wealth and resources

Economic alternatives and childhood poverty

Current national and international economic policies are exerting ever more direct pressures on children's lives and futures. This paper reviews key concerns and contradictions in neoliberal economic policies' effects on childhood. Alternative feminist and green economics and critical theory critiques of neoliberalism are summarised and their implications for childhood poverty are considered. In conclusion there are suggestions about sustainable green economics for childhood to take account of the problems of advocating perpetual economic growth in a finite planet. Copyright © 2008, Inderscience Publishers