Choosing for and with children: consent, assent and working with children in the primary care setting.

The complex ethical and legal concepts of consent, assent, capacity and best interests merit a fine-grained scrutiny in the context of providing health care for children. Empirical evidence points to children being much more competent than we are often prepared to admit and their views and concerns not always being given sufficient attention. Various models and guidelines help practitioners to redress this deficit and to assist in shared decision making between children and their parents. In addition, there is a case for adopting a more family centred perspective rather than an adversarial legalistic approach.