Abstract
It was deeply disappointing to read in your April edition an essay 1 about provision of paediatric care which treated children solely as objects of care, and all parents and families homogenously. Concepts such as the ‘captive patient' and ‘family-centred care' may have had some past value in initiating debate, but cannot be accepted as modern terms summarising care delivery choices.
Children are individuals, with preferences and opinions, and often they are expert in their own condition. Listening to children's voices is fundamental, not even acknowledging them is unacceptably demeaning.
Families and parents too are individual, with different competencies, and also individual co-responsibilities for other children, other caring duties, and home making and income creation roles. Some parents have other problems such as their own ill health. Not all parents have the same degree of child bonding, and children's individuality and autonomy develop according to both age and family context.
All healthcare should be delivered respectfully, sensitive to the individual, and children are no exception. Children should not be disempowered, but should have a voice in how they are cared for and supported. While facilities to enable full parental involvement in paediatric healthcare are essential, their use should be largely the choice of the child and the parents. It is paradoxical that the essay regrets children's reduced autonomy for outdoor play, yet eliminates their expression of preferences on their own healthcare.
Clearly, there is a long way to go before personalised care is fully understood let alone practised universally, and before children are treated as individual people, with rights and choices.