Children's participation in consultations and decision-making at health service level: A review of the literature

Background: The past decade has seen a growing recognition in Ireland and internationally that children and young people have a right to participate in matters that affect their lives. Objectives: To critique the research literature on children's, parents and healthcare professionals' experiences of children's participation in consultations and decision-making within the healthcare setting. Method: The literature was obtained from electronic databases, books, and journals focusing on work published in between 1993 and 2007. Results: Despite the importance of consulting with sick children, their views are rarely sought nor acknowledged within the healthcare setting. Children are rarely involved in decision-making process and appear to occupy a marginalized position in healthcare encounters. Healthcare professionals and parents play a significant influence on whether children's efforts to participate are facilitated and supported in the hospital setting. Conclusions: There is a need for further research to explore health professionals' and parents' perspectives on children's participation in consultations and decision-making, as clearly they have reservations/concerns about children's active involvement in such matters. This information could be used to develop guidelines that will assist professionals and parents in facilitating and supporting children's participation. (C) 2008 Elsevier Ltd. All rights reserved.