Article Text

Download PDFPDF
Call for moral recognition as part of paediatric assent
  1. Jared Smith,
  2. Jennifer Blumenthal-Barby
  1. Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Jared Smith, Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX 77030, USA; smith.jaredn{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

In ‘Reification and Assent in Research Involving Those Who Lack Capacity’, Smajdor argues that adults with impaired capacity to grant informed consent (AWIC) are often excluded from participating in biomedical research because they cannot provide informed consent, leading to decreased chances AWIC will benefit from such research. Smajdor uses Honneth’s concept of reification to propose that securing assent (rather than consent) in cases involving AWIC offers patients moral recognition that is not tied to their capacities. Assent provides this recognition by including the patient in a shared moral sphere, highlighting her agency and worth without reducing her to her incapacity or a thing-to-be-managed. Assent also avoids grounding in, or a reliance on, the future development of autonomy (pp.5–6).1

Our recent research on patient and caregiver perspectives of potential paediatric deep brain stimulation (pDBS) for refractory obsessive–compulsive disorder (OCD) and dystonia demonstrates that paediatric neurosurgery patients desire the kind of recognition Smajdor associates with assent, and their caregivers largely agree.2 3 Since (generally) paediatric patients in the USA are unable to grant informed consent, their caregivers must provide it instead. This raises the question of how to properly integrate paediatric patients into the DBS decision-making process.

One dimension along which this is evident is that …

View Full Text


  • Contributors JB-B is the lead PI for the grant project on which this commentary is based, contributed to conception and design of the commentary, critically revised the proposal and commentary, and gave final approval. JS contributed to analysis and interpretation, drafted the proposal and manuscript, and revised manuscript.

  • Funding This research is funded by a NIMH grant (#1RF1MH121371-01).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles

Other content recommended for you