Informed decision making and refusal of treatment

Abstract Informed consent serves as the cornerstone of modern bioethics. Ideally, patients should be provided with enough information to make informed decisions regarding proposed tests or treatment options. However, as the following cases suggest, informed consent in the emergency setting can be very difficult, because time is limited, injuries often require immediate attention, and there may be competing claims regarding who has decisional authority. What are the elements of consent? What happens when conflicts arise between pediatric patients and their parents? When should physicians treat minor patients without parental consent? This article uses three illustrative cases to explore the role of informed consent in pediatric emergency medicine.