A Narrative Approach to Assent in Pediatrics

While narrative approaches to clinical care of adults are lauded in medical literature and training, scant attention is directed to narrative’s potential in the realm of pediatric clinical care. The narrative structure inherent to a narrative medicine framework is particularly well-suited to contextualize clinical care for children while also fostering a child’s decision-making capacity. This article proposes a narrative model of pediatric assent that adapts three steps familiar in narrative models: Narrative Emplotment, Stimulation of Imagination, and Invitation of Assent while Preparing for Dissent. Narrative Emplotment refers to the contextualization of clinical care through the construction of a narrative in partnership with a pediatric patient. Stimulation of Imagination refers to the exploration of potential future options with a child through the use of narrative-directed questions. Finally, Invitation of Assent while Preparing for Dissent refers to pre-emptive steps taken to re-contextualize care following dissent from a child.