Issues of consent and competency

by Keely Blanch

I started out meaning to write this post about researching in 'over-researched' fields, but as is often the case another idea popped up as I sat down to write. Consent, specifically issues of consent and competency to give that consent, by young people. At what age is a young person considered capable of giving consent for participation in research or other activities?

This thought was spurred by a story that has been in the media over the last few days regarding a young woman, in a metal cage, on the front of a 'monster truck' that was then driven through a wall of fire. It turns out that this young woman is only 13 years old, which raises questions regarding her ability to consent to what could be described as a calculated risk. 

There are differing understandings of young people's ability to consent in different contexts. The ways we understand children and childhood have changed within a research-based context. Recognising the rights of the child, young people are regarded as competent agents, capable of giving assent, and often consent, to participating in research. 

However the age where the line shifts from requiring parental consent and child assent, to requiring child consent and perhaps parental assent is blurry. For instance, at a recent conference I heard one researcher argue his ethics committee negated children's ability to consent under the age of 16, an age perhaps influenced by legalistic determinations of ability to consent to intercourse. On the other hand, some researchers argue we should consider the competency of young people rather than chronological age as a marker for providing consent. Researchers and ethics committees can vary in how they determine the competency of a young person to give consent. 

As I listened to the radio interview with the Monster Truck owner, I began to compare this situation to other contexts. How does this compare to children who perform in circuses? What if this was a movie set - would Sir Peter Jackson be allowed to use a 13 year old in a potentially dangerous stunt? Can this be compared to young people's rights to consent, or not, regarding medical procedures? I think, like many ethical decisions, it depends. It depends upon factors such as risk, harm, benefits and whether the young person can be deemed competent to understand how these situations will affect them, and how their bodies, thoughts, and words will be used by others.

If the Monster Truck stunt had been a research project, it would have had to go through an ethics committee who would have considered these factors. An ethics committee acts to protect the safety of research participants. The researcher and ethics committee would have considered the risk of harm versus the benefit to the young person. They would have insisted that everyone involved was fully informed and understood the ramifications. They would have wanted to see a plan to minimise risk, and they would have wanted an indication that the young person would gain some benefit from participating. 

Given that, at the time of writing, the only voice in the media regarding this stunt is that of the owner, we cannot really ascertain whether this young person was fully informed regarding risk. We are forced to accept the owner's assertion that she freely consented and wanted to participate at face value, and it seems the parents also consented to the stunts. 

However, I am still left pondering some points:

- from what I heard on the radio, apparently the stunt evolved from discussions over dinner between the owner and the young person's parents, who are old friends. Potentially, this could raise issues of coercion, and the ability to freely give consent.

- it is unclear whether either the young person and her parents have been involved with Monster truck stunts before, whether they were fully informed of potential risks, and whether they fully understood those risks. I return to the concept of the circus performers. One might assume that growing up in an environment and seeing the training required, and the impact of mistakes, may provide an experiential understanding of risks involved with performances. A quick google provided several media reports (here and here) that talk of the training and time required to learn stunts. Being told what to do over a few weeks is different to the intensive training that leads to an automatic reaction when/if something goes wrong. I'm left wondering if this young person received training on what to do if she caught fire, whether she had practice runs on the stunt, whether she practiced getting out of the cage, and whether there was an arranged signal for the driver if she wanted to call off the stunt at any point.

- What benefit did this young person receive from taking part? For instance, her father claims she wants to be a stuntwoman, and successfully completing the stunt may have boosted the young person's self-confidence, but in a commercial venture, could/should she have expected to be paid for her participation?

Of course, instances like this are not research. Such events are not dependent upon approval by an ethics committee. As such, consent, and the ability to give consent, becomes an issue for the law. We only have to look at the varying (socially-constructed) ages of consent (without additional parental consent) and/or competency for choices such as smoking (16), sex (16), driving (16), voting (18), marriage (18), joining the police force (18), and gun licence/ ownership (16) to see that judgments on competency and ability to consent to processes vary widely. 

Which raises some questions - should there be age related markers of competency to consent? Or should we consider other ways of assessing competency, and if so, how? And in research, which is more important - the competency or the chronological age of  participants?

[Do check out our resources page which has links to a couple of sites about researching with children.]