This assignment will be an in depth exploration of consent to treatment in children as an issue affecting practice .An analysis of both ethical and legal perspectives relating to consent to treatment will be explored and the possible solutions will be highlighted .In ethical issues the following will be looked at : autonomy ,beneficence, non-maleficence and justice. The legal issues such as duty of care and decision making will be analysed .The parental and professional responsibilities and their implications will be dealt with. The attached scenario examines some of the ethical and legal issues that may arise concerning parental decision making regarding surgery on children. It uses two cases, each of which raises issues concerning children’s competence to be involved in decisions; the notions of best interests and best health interests; how interests are related to wishes and welfare the role of parents in assessing best interests and parental rights in deciding for their children.The scenario is attached on appendix 1

1.Ethics is relevant to clinical, practice-based issues and it affects all areas of nursing practice. It is concerned with right or wrong although agreeing on what is right can be challenging (Chaloner 2007).Ethics and law are closely related

2.In the healthcare practice the Utilitarian ethics (Bentham 1748-1932 and Mills 1806-1873 and the Deontological theories cited by Cooke and Hurley (2008)are commonly used to resolve moral dilemmas. The two theories take opposing views about the rightness and wrongness of acts and decisions. Patients are individual persons with their own opinions and aims in life, which require them to act intelligently in what they do. In order for them to act intelligently they need to be allowed to make their own decisions and given the right information. Deontology is a theory that says decision should be based on whether or not an action is morally right with no regard for the result or consequences. Utilitarianism is a theory that is bases decision on the greatest good for the greatest number (Videbeck 2006).

Autonomy is the principle of self determination, freedom of choice or being your own person (Parker and Dickenson 2001). Chaloner (2007) viewed autonomy as the idea of moral reflection, for example choosing your own moral position and accepting responsibility for the kind of person you are In agreement with above definition ,Hendrick (2004) equated autonomy with integrity, dignity and independence and identified it with qualities such as self assertion and critical reflection .Autonomy literally means self rule. Respect for autonomy demands that healthcare professionals respect autonomous choices made by patients and that patients are not deceived about their diagnosis (Brazier 2003).For example the nurse respects the client’s autonomy through patient’s rights, informed consent and encouraging the client to make choices about his or her health care.

Videbeck (2006) defined the principle of beneficence as one’s duty to benefit or to promote good for others. Maclean (2001)viewed beneficence as a positive obligation to provide and to balance benefits against risks and costs . From a nursing perspective the responsibility for the patient’s well being and avoiding actions that are detrimental to them as laid down within the code of conduct Therefore the principle of beneficence supports the obligation to do good. Nonmaleficence is the requirement to do no harm to others either intentionally or unintentionally(Videbeck 2006).It requires that one should not inflict harm to others .Contrary to beneficence ,nonmaleficence is a negative obligation which can only occur through an act of commission to inflict harm on others as opposed to an act of omission even when such an act of omission results in harm to another person.

Justice refers to fairness ,that is treating all people fairly and equally without regard for social or economic status ,race ,sex, marital status religion or cultural beliefs (Stauch et al 2006, Videbeck 2006).The above principles have a significant in meaning in health care. Therefore the nurse can minimise the risk of lawsuits through safe competent nursing care and accurate documentation. For instance ,the clause of the Code of Nursing and Midwifery Council (NMC 2008) states that nurses have a duty of care to their patients who are entitled to receive safe and competent care.