Which statement accurately summarizes pediatric consent and assent?

• A. Parents/guardians provide consent; children provide age-appropriate assent when capable; emergencies may override.
• B. Children provide consent; parents provide assent.
• C. Only parents provide consent; children cannot assent.
• D. Assent is never required.

Answer: (B)

The key idea is that caring for a child’s medical decisions involves two players: the parent or guardian who gives formal permission, and the child who is always asked for assent when they can understand and participate. The parent’s consent is the legally required permission for treatment, while the child’s assent is an affirmative agreement or willingness to participate that respects the child’s developing autonomy. Assent is not the same as consent, but it should be sought whenever feasible and appropriate for the child’s age and understanding. In emergencies, care can proceed without prior consent to protect the child’s health, using presumed consent, and then the parents are informed and consent is sought as soon as possible.