Permission and assent for clinical research in pediatric anesthesia

Informed consent for participation in research with children must be modified by using proxy permission and assent of the child. Requests must be tailored in a manner that enables the proxy to safeguard the interests of the child and, of equal importance, also enables the child to give meaningful assent. To increase the likelihood that the rights and interests of children participating in clinical research are protected, the person requesting consent must engage in a conversation that covers the specific needs of both the proxy and the child. Congruent with parental preferences regarding consent for clinical studies in pediatric anesthesia, the optimal time to obtain consent for clinical research in pediatric anesthesia might be well in advance of admission to the hospital, yet further empirical data are needed to develop optimal methods of obtaining informed and voluntary permission and assent in this setting.