Paediatric Consent and Capacity

Twelve year old Katie walks into your anaesthetic room holding her favourite green bunny, her mother and father in tow, ready for her dental extraction under general anaesthesia.

• She's been waiting for fourteen weeks
• The surgeon has been through the consent
• You met them this morning and established excellent rapport as you always do
• Mum is happy
• Dad is slightly less happy
• Kid is hungry

You start your usual script:

"Alrighty then Katie, come hop up on the bed and I'll show you the cool machine with the big green balloon that we talked about earlier."

Katie takes one look at the anaesthetic machine, the ODP, and the airway trolley, and promptly starts screaming.

"I'm not having it, I don't want it, leave me alone, I'm not doing it!"

The facial expression on Mum's face suggests this is neither unexpected nor an infrequent occurrence.

'Darling we talked about this, and we agreed, you need this done to make your teeth better, then we can go home and play.'

"NO!"

Forty minutes of encouraging, suggesting and bargaining later, you've made little progress.

Mum looks at you with desperation, 'Can we not just pin her down and get on with it?'

Dad says, 'You can't force her if she's saying no!'

What do you do?

Let's find out.