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PEDlATRIC BILL OF RIGHTS

National Association of Children's Hospitals and Related Institutions

1975 

The Pediatric Bill of Riqhts was endorsed and recommended by the (U.S.) National Association of Children's Hospitals and Related Institutions on 25 February 1975. A somewhat different version had been approved and pub­lished in 1974. Proposed for use in health care institutions, the Bill has historic significance because it has served as a focal point for discussions of the healthcare rights of children. Furthermore, children's rights to medical and health care, including those mentioned in this Bill, are increasingly being acknowledged in U.S. Iaw, with some variation among the states.

This Bill draws on earlier statements: (1) the Children's Charter, from the 1930 White House Conference on Child Health and Protection; (2) the Declaration of the Rights of the Child, approved by the United Nations in 1959; and (3) The Rights of Children: Report of the Forum, from the 1970 White House Conference on Children.

The Pediatric Bill of Rights raises the question of how to provide for children's rights and needs in relationship to parental rights and responsibilities, the rights and autonomy of physicians, the rights of health-care institutions, and the rights of the state (e.g., in preventing the spread of disease). The basic issue seems to be whether, in articu­lating the rights and the autonomy of children together with the corresponding duties of others, the assumption should be that the child's interests are best protected by the physician; by parents, guardian, or legal custodian; or by the state. Even in giving its endorsement to the Bill, the National Association of Children's Hospitals and Related Institutions indicated that it did not intend to deemphasize or negate the rights and responsibilities of parents in con­nection with the medical care of their children, but intended only to indicate that the right of the child to receive ap­propriate medical care and treatment should be regarded as paramount in cases where parents' views might be in direct conflict with the child's desire or need for appropriate care or treatment.

Another document which gives more detailed attention to the responsibilities of parents vis-a-vis the consent of minors is "A Model Act Providing for Consent of Minors for Health Services," Pediatrics 51 (1973): 293-296, which was approved by the Council on Child Health of the American Academy of Pediatrics .

 

Article 1. Every person, regardless of age, shall have the right of timely access to continuing and competent health care.

Article 2. Every person, regardless of age, shall have the right to seek out and to receive information concerning medically accepted contraceptive devices and birth control services in doctor-patient confidentiality. Every person, re­gardless of age, shall have the right to receive medically prescribed contraceptive devices in doctor-patient confiden­tiality.

Article 3. Every person, regardless of age, shall have the right to seek out and to receive information concerning venereal disease; and every person, regardless of age, shall have the right to consent to and to receive any medically accepted treatment necessary to combat venereal disease in doctor-patient confidentiality .

Article 4. Every person, regardless of age, shall have the right to seek out and to accept in doctor-patient confi­dentiality, the diagnosis and the treatment of any medical condition related to pregnancy. Every person, regardless of age, shall have the right to adequate and objective counseling relating to pregnancy and abortion in doctor-patient confidentiality; and every person shall have the right to request and to receive medically accepted treatment which will result in abortion, in doctor-patient confidentiality.

Article 5. Every person, regardless of age, shall have the right to seek out and to receive psychiatric care and counseling in doctor-patient confidentiality.

Article 6. Every person, regardless of age, shall have the right to seek out and to receive medically accepted counseling and treatment for drug or alcohol dependency in doctor-patient confiden­tiality.

Article 7. Every person, regardless of age, shall have the right of immediate medical care, when the life or health of such person is in imminent danger. The decision of imminent danger to the life or health of such person is a deci­sion to be made solely by the attending physician; and the attending physician shall decide which treatment is medi­cally indicated under the circumstances.

Article 8. Any person, regardless of age, who is of sufficient intelligence to appreciate the nature and the conse­quences of the proposed medical care, and if such medical care is for his own benefit, may effectively consent to such medical care in doctor-patient confidentiality.

Article 9. In every case, in which a child is being examined by, being treated by, or under the medical care of a qualified medical practitioner, and where, in the opinion of that qualified medical practitioner, the child is in need of immediate medical care and where the parent or legal guardian of such child refuses to consent to such needed imme­diate medical treatment, said medical practitioner shall notify the juvenile court or the district court with juvenile jurisdiction immediately. The juvenile court or the district court with juvenile jurisdiction shall immediately appoint a guardian ad litem, who shall represent the child's interests in all subsequent legal proceedings. The juvenile court or the district court with juvenile jurisdiction shall immediately set a date for hearing, not to exceed 96 hours from the receipt of the initial report. The court shall determine at the hearing, based upon medical and other relevant testimony and the best interests of the child, whether or not said medical treatment should so be ordered by the court.

Article 10. Every person, regardless of age, shall have the right to considered and respectful care. During exami­nations, every attempt shall be made to insure the privacy of every patient, regardless of age; and every person, re­gardless of age, has the right to know observers are present. what role the observer may have in regard to the pa­tient's treatment and shall have the right to request that observers remove themselves from the immediate examining area.

Article 11. Every person, regardless of age, shall have the right to know which physician is responsible for his care. Every person, regardless of age, shall have the right to be informed concerning his diagnosis, his treatment and his prognosis in language that is readily understandable to him. Every person, regardless of age, shall have the right to ask pertinent questions concerning the diagnosis, the treatment, tests and surgery done, on a day-to-day basis in a hospital setting; and every person, regardless of age, shall have the right to immediate response to the best of the at­tending physician's knowledge and in language that the patient clearly understands.

 

[The text of the Pediatric Bill of Rights is found in Brian G. Fraser, "The Pediatric Bill of Rights," South Texas Law Journal 16 (1975): 245-307, and is reprinted here with the permission of the South Texas Law Journal.]