Informed Consent
Working in a public school system, one has to adhere to different guidelines when obtaining informed consent. First and foremost, one is obtaining parental or guardian consent rather than from the individual. A student has to be eligible for special education services under the Individuals with Disabilities Education Act before a referral for a physical therapy evaluation can be considered. This document addresses more legal than ethical matters. It states that the parent or guardian gives consent to the school district to evaluate my child and in giving consent that it is voluntary and may be revoked at any time (ISPE2102- Parent Consent for Evaluation- English, 2015). Given the demographics where I am employed this consent
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De Bord (2014) states that children do not possess the decision-making capacity to provide informed consent. By definition, consent is given for an intervention for oneself; therefore parents are only providing informed permission or authorization (De Bord, 2014). In working with children, I am dealing more with assent. This assent takes many forms depending on the individual child’s developmental and/or cognitive level. This leads to two other elements of informed consent, understanding and disclosure. In the preschool age children, frequently they do not understanding my role as a physical therapist and seeking compliance is through play or rewards. With older children, I attempt to disclose as much information on my treatment and involvement with them in the school environment depending on their cognitive level. I also have students that are 18 years or older. Regardless of their capacity, if a parent does not have guardianship of their child that may demonstrate impaired cognition, informed consent must be obtained by the student. In these situations, I make sure the parent is present and also obtain their permission. For example, recently I carried out an evaluation for a new wheelchair with an 18 year old student. His parents were made aware of the evaluation through emails and phone conversations. To have full understanding of the final decision process and required paperwork, the student’s father was in