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With comments from a young person’s perspective
In this paper I describe my own personal approach to children’s rights in health care. This has developed from apprenticeship to good role models, from listening to children,and from voluntary organisations which represent children. The National Children’s Bureau has been a valuable source of advice (www.ncb.org.uk).
The UN Convention on the Rights of the Child is an essential tool for individual health care as well as public health practice. Any paediatrician who peruses the Convention carefully will find many articles with health implications.1 Table 1⇓ lists the essential health care related articles. I have asterisked the articles which are of relevance to every consultation with a child. The other articles are important because they impose an advocacy function on us as paediatricians.
I will deal with paediatric practice in relation to the clinic consultation, to the provision of information, to advocacy for children in difficulty, and to participation. Finally a mention is made of teaching in this field.
The chief principle underlying my practice is that of child autonomy and respect for the child’s separate identity. The child is as much a person as their parent and deserves respect and separate consideration. Children and young people (hereafter CYP) often say, “The doctor never spoke to me”. The child is the primary client and the parents secondary, though essential to the child’s wellbeing. This will not be new to most paediatricians.
Hence my aim is to communicate directly with the child in every consultation. This is regardless of age. The conversation begins with the child, though this can be limited if he or she is under 3—and some children do not open up easily. However, it is good practice, …