Children’s Rights in Healthcare
There’s a story in my family that my mum loves to share. When I was a young child, I was often unwell and needed frequent blood tests. One day, she took me to a hospital where her friend—a nurse I knew—was supposed to perform the procedure. I remember resisting so fiercely that it took two people to hold me down while the nurse did her job. In my distress, I screamed, “I hate you! I hate you!” causing my mother great embarrassment. Looking back, I can see I wasn’t prepared for what was happening. I don’t recall being informed about the procedure, and my mum, understandably, can’t remember all the details either.
Isn’t this experience a reality for many children in healthcare settings? From the moment they are born, young children are assessed, tested, and treated. As they grow older, this need for medical care continues. While adults generally understand their rights—knowing they can refuse treatment or leave a hospital—what about the rights of children? It’s likely that many adults, let alone the children themselves, would struggle to answer this important question. The truth is, there are numerous rights that pertain to healthcare for children, and understanding these rights is crucial to ensuring their well-being.
18 out of 54 Articles of the United Nations Convention on the Rights of the Child are linked to children’s health. In a nutshell:
Children have rights to accessing health services without discrimination and to be hospitalised when necessary.
Hospitalised children have the right to play and to benefit from recreation and education. They have the right to their privacy being respected.
Children and their families have the right to be informed and to not be separated without agreement.
Children also have the right to participate in decision making regarding their treatment.
(UNCRC, 1989, Georgousopoulou, Voutetakis, Galanis, Kourti, Zartaloudi, Koutelekos, Dousis, Kosmidis, Koutsouki, Pappa, 2023)
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Because of such a wide spectrum of rights and needs of our young citizens, there actually is a document that summarises all the rights: The Charter on Children’s Rights in Hospitals. The Charter is aligned with the UNCRC General Comment No. 15 (2013) on the child's right to the highest attainable standard of health (Article 24), as well as with the UNCRC General Comment No. 4 (2003) on adolescent health and development (EACH,2024). You can check the website HERE and download a brochure about the rights HERE.
But in case you just want to quickly see what are children’s rights in healthcare without having to look into them on a separate website, below you will find a short and uncomplicated overview of each article of the charter:
Article 1
Children shall be admitted to hospital only if the care they require cannot be equally well provided at home or on a day basis.
Before admitting a sick child to the hospital, all possible care options should be considered, such as care at home, in a day clinic, or in another healthcare setting.
If the child needs to go to a hospital, it should be as close to home as possible, while still providing the necessary level of care. The family's situation should also be taken into account, and care must follow the standards of the EACH Charter.
Children’s rights must be respected no matter where they receive care. Once admitted, the child’s condition should be regularly reviewed, and the family's needs and the care level reassessed to avoid unnecessary stays. Parents should always receive the information, support, and assistance they need, wherever their child is being treated (EACH, 2024).
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Article 2
Children in hospital shall have the right to have their parents or parent substitute with them at all times.
Children have the right to stay with their parents when they are sick, and this is an important part of their care. The child’s best interests should always come first. If parents cannot stay, the child should be accompanied by someone they know and trust for support.
Children have the right to have their parents with them 24/7 in any situation where they need support, including during treatment, anesthesia, recovery, unconsciousness, or after birth. This applies to all healthcare settings, such as intensive care, emergency rooms, and isolation units (EACH, 2024).
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Article 3
(3.1) Accommodation should be offered to all parents and they should be helped and encouraged to stay. (3.2) Parents should not need to incur additional costs or suffer loss of income. (3.3) In order to share in the care of their child, parents should be kept informed about ward routine and their active participation encouraged.
Staff should encourage and support all parents to stay with their child in the hospital, without imposing any criteria. Hospitals should provide facilities for parents, such as a bed, food, and bathroom access, at no extra cost. Parents shouldn’t lose income or face extra expenses for staying with their child or arranging care for siblings.
Parents should be informed and involved in their child’s daily care and treatment, and staff should respect their choices. By participating in their child’s care, parents gain confidence, which can help shorten the hospital stay. Staff should provide training, guidance, and emotional support to help parents care for their child (EACH, 2024).
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Article 4
(4.1) Children and parents shall have the right to be informed in a manner appropriate to age and understanding. (4.2) Steps should be taken to mitigate physical and emotional stress.
Children and their parents have the right to know what will happen before any medical procedure. Information should be clear, simple, and appropriate for the child's age and understanding. It should help children feel in control, and parents should be fully informed to support their child.
Staff should encourage questions, provide support, and ensure both the child and parents understand. Information should be given continuously and in a calm, private setting, ideally in the family’s language.
Children are entitled to adequate pain relief and should be protected from stress and discomfort. Emotional support should be offered to both the child and parents, especially during difficult situations. Families should have access to social services, psychological support, and self-help groups (EACH, 2024).
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Article 5
(5.1) Children and parents have the right to informed participation in all decisions involving their health care. (5.2) Every child shall be protected from unnecessary medical treatment and investigation.
Children have the right to participate in decisions about their healthcare, and staff should provide clear, timely information and respect their views. Trust and good communication are essential, and children can express their opinions through words, play, or body language. Parents' observations are also important.
Informed consent from both children and parents is required for any treatment or research. Children must be protected from unnecessary medical procedures, and participation in research requires careful oversight to ensure their safety. Families can withdraw consent at any time without affecting the child’s care (EACH, 2024).
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Article 6
(6.1) Children shall be cared for together with children who have the same developmental needs and shall not be admitted to adult wards. (6.2) There should be no age restrictions for visitors to children in hospital.
All children in hospitals need an age-appropriate environment that provides mental, emotional, and physical stimulation to help reduce anxiety during their stay. This includes access to rest, entertainment, and activities with other children who have similar needs.
Children should not be placed in the same areas as adults, and separate facilities must be available for children and adults to ensure comfort and respect. Special accommodations should be made for adolescents, and any form of discrimination must be avoided.
There should be no age restrictions for visitors; siblings and friends can visit as long as it is safe for the child and the visiting children (EACH, 2024).
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Article 7
Children shall have full opportunity for play, recreation and education suited to their age and condition and shall be in an environment designed, furnished, staffed and equipped to meet their needs.
Children have the right to an environment that meets their needs, no matter their age or situation, whether in hospitals, daycare, or other healthcare facilities. The design of these places should include features suitable for all ages and health conditions.
There should be enough qualified staff to support children's needs for play, recreation, and education. All staff should understand the importance of play for children. Facilities must offer plenty of opportunities for play and creative activities, even for those in isolation, and ensure that children receive education at their appropriate level (EACH, 2024).
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Article 8
Children shall be cared for by staff whose training and skills enable them to respond to the physical, emotional and developmental needs of children and families.
Staff caring for children need specialized training and sensitivity to meet the unique needs of children and their parents. Hospitals must ensure that children are treated by qualified pediatric staff. If non-pediatric staff need to treat a child, they must do so under the supervision of trained pediatric professionals.
All staff should receive ongoing training and be equipped to recognize signs of abuse and neglect. Children should have access to confidential health advice and counseling, even without parental consent, especially in cases of abuse or reproductive health needs.
Parents should receive emotional support during critical situations, particularly when a child is facing life-threatening issues. Palliative care should begin upon diagnosis of a life-limiting illness, focusing on reducing distress and involving the family and a specialized team. When a child dies, families should receive compassionate support, and staff should have training to handle bereavement sensitively (EACH, 2024).
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Article 9
Continuity of care should be ensured by the team caring for children.
Continuity of care means ensuring that a child receives consistent treatment from the same team of staff, both in the hospital and when transitioning home or to daycare. This involves teamwork among family and healthcare providers, with timely sharing of information and necessary resources.
Teamwork should consist of a small group of knowledgeable individuals working together to support the child's physical, emotional, and social well-being. For children with long-term health issues, preparation for a smooth transition to adult services should begin when the adolescent feels ready and continue until they are confident in the new care situation (EACH, 2024).
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Article 10
Children shall be treated with tact and understanding and their privacy shall be respected at all times.
Caring for children with sensitivity means respecting their rights to enjoy being children while considering their dignity, individual needs, and developmental stage. It involves recognizing any disabilities or special needs and ensuring staff are friendly and approachable.
A supportive atmosphere should also respect the child's cultural and religious background, as well as their wishes regarding privacy, which can change as they grow.
Children's privacy must always be protected, including during exams and personal care activities. They should not be exposed to situations that diminish their self-respect, have the right to be alone, communicate privately with staff, and spend time with close family and friends without interruption.
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Georgousopoulou et al. (2023) argue that respecting the rights of children in the healthcare settings will improve children’s well-being and health. They conducted an interesting research among healthcare professionals in Greece, to find out how are children’s rights respected in the hospitals. Important to note here: In Greece, the UNCRC was incorporated into national law in 1992 and is specifically mentioned in an article of the Constitution of the Hellenic Republic (Georgousopoulou et al., 2023). That means children’s rights have much more legal binding. The study of Georgousopoulou et al. (2023) showed that the Charter of Children’s Rights in Hospitals was not commonly displayed or made accessible to professionals, parents or children. As a matter of fact, just a small number of study participants were aware that such a Charter exists! Additionally, just short of 30% of healthcare professionals that took part in the study, believed that hospital practices are in line with UNCRC.
And there are other challenges that have been demonstrated in a number of studies, such as:
lack of possibility for parents to be present in certain hospital areas,
admitting children who could actually be cared for at home,
limited possibilities for children to complain or being involved in decision making
Respect for age, gender and privacy (Georgousopoulou et al., 2023).
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One particular challenge I want to point your attention to, is the difficulty of children to engage in recreational activities and also having no access to education during the hospital stay. Some other studies also show that oftentimes there are no facilities for children to allow for play and learning, but also there are no trained staff to support those needs and rights (Georgousopoulou et al.,2023, Albert-Lőrincz C., 2018, Piira, et al., 2005, Migone, Mc Nicholas, Lennon, 2008). I believe it is an alarming state, considering play is such a fundamental children’s right. Play provides many benefits in relation to a holistic development of a child, but also has healing properties. Through play children have the opportunity to get prepared for treatments and examinations, but can also process these and heal from traumatic moments.
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I think it is clear that there is a need for more advocacy for children’s rights in healthcare settings, but also need for more training on the topic. Children’s rights should be a recurring topic on the agenda. In my research to write this article I actually came across a very useful tool in the form of a checklist, to undergo a self-audit for healthcare professionals and healthcare institutions, in regards to children rights. This tool was developed by World Health Organisation (WHO) and you can access it HERE.
As we reflect on the rights of children in healthcare settings, it’s essential to remember that every child deserves to feel safe, respected, and heard. The experiences that shape our early interactions with medical environments can have lasting effects, both positive and negative. Just like my own childhood memory, many children find themselves facing uncertainty, fear, and discomfort during their treatment.
We must strive to create a healthcare system where children are not just passive recipients of care but active participants in their own healing journey. This involves not only educating healthcare professionals about children’s rights but also fostering a compassionate environment where every child can express their feelings, concerns, and wishes.
By embracing the principles outlined in the Charter on Children’s Rights in Hospitals and the UNCRC and advocating for their implementation, we can work towards a future where every child’s dignity is upheld, their voices are heard, and their experiences are validated. Let us be the advocates for change, ensuring that no child has to feel alone, frightened, or misunderstood in their moments of vulnerability. Together, we can build a more empathetic healthcare system that nurtures not just the body, but the spirit of our children, allowing them to thrive in both health and happiness.
Literature:
Albert-Lőrincz C. (2018) The situation of pediatric patients' rights in the Transylvanian healthcare. Orvosi Hetilap, Mar;159(11):423-429. DOI: 10.1556/650.2018.30999. EACH (2024) Promoting Children’s Rights and Welfare in Healthcare. https://each-for-sick-children.org/each-charter/ Georgousopoulou, V., Voutetakis, A., Galanis, P., Kourti, F.E., Zartaloudi, A., Koutelekos, I., Dousis, E., Kosmidis, D., Koutsouki, S., Pappa, D. et al. (2023) Assessing the Respect of Children’s Rights in Pediatric Hospitals. Medicina, 59, 955. https://doi.org/10.3390/Medicina59050955Migone, M.; Mc Nicholas, F.; Lennon, R. (2008) Are we following the European charter? Children, parents and staff perceptions. Child Care Health Development, 34, 409–417.Piira, T.; Sugiura, T.; Champion, G.D.; Donnelly, N.; Cole, A.S. (2005) The role of parental presence in the context of children’s medical procedures: A systematic review. Child Care Health Development, 31, 233–243.United Nations Human Rights Office of the High Commissioner (1989) Convention on the Rights of the Child, Retrieved from https://www.ohchr.org/EN/ProfessionalInterest/Pages/CRC.aspx
World Health Organisation (2024) Children’s Rights in Hospital. https://www.who.int/europe/publications/m/item/children-s-rights-in-hospital