Qualitative Responses
The final survey question asked the respondent to describe his or her
responses to the scenarios. Thirteen physicians (65%) completed this.
There were a few common themes that emerged. First, respondent’s
viewpoints were often guided by legal age-related constraints. Second,
there was a tension between the legal decision-making authority and a
desire to grant the child decision-making capacity in certain contexts.
Third, many viewed their position as one of reconciling between the
various stakeholders and attempting to come to an agreement. The
following excerpts from respondents illustrate these themes:
“The age of majority is 18 - regardless of ”who is the major
decision maker, parents or children” legally the parents have the final
say until age 18.”“I believe in all of the scenarios that currently the parents are
the final decision makers based upon age. However, my opinion is that
regardless of age, if Anna understands the components of the procedure,
is able to describe the risks/benefits and is involved in her own care,
that she should be eligible to make her own decisions. Although legally
she is still a minor, I believe the criteria listed above would
demonstrate understanding of the procedure and should allow for her to
give informed consent regarding her medical decision making.”“Rather, my role in shared decision making is to try to help them
have the opportunity to share their thoughts and feelings, find common
ground, and determine the best course of action for the patient given
their goals.”
These common themes highlight many of the challenges of implementing
pediatric SDM.