Which statement best describes assent in pediatric chemotherapy?

• A. Children should assent whenever capable; parental consent is still required for treatment decisions.
• B. Assent is legally binding and replaces parental consent.
• C. Children should assent when capable; parents provide consent; clinicians protect the child’s best interests.
• D. Assent is optional and not necessary in pediatric care.

Answer: (C)

Assent means involving a child in decisions about their care to the extent they can understand, while parents still provide the formal permission for treatment. In pediatric chemotherapy, the parents hold the legal authority to consent to treatment, but honoring the child’s developing autonomy by seeking their assent is ethically important and helps protect the child’s welfare. The best choice captures this balance: children should assent when capable; parents provide consent; clinicians protect the child’s best interests. This reflects that assent is a respected part of the process, not a binding substitute for parental consent, and not optional. It also acknowledges the clinician’s duty to explain in developmentally appropriate language, assess understanding, and ensure the treatment plan serves the child’s overall best interests, even if the child’s preferences and the parents’ decisions align or diverge.