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Health Promotion Journal of Australia Health Promotion Journal of Australia Society
Journal of the Australian Health Promotion Association
RESEARCH ARTICLE

Ethical considerations in investigating youth alcohol norms and behaviours: a case for mature minor consent

J. Hildebrand A , B. Maycock B C , J. Comfort A , S. Burns A , E. Adams A and P. Howat B
+ Author Affiliations
- Author Affiliations

A Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Perth, WA 6845, Australia.

B School of Public Health, Curtin University, Perth, WA 6845, Australia.

C Corresponding author. Email: b.maycock@curtin.edu.au

Health Promotion Journal of Australia 26(3) 241-245 https://doi.org/10.1071/HE14101
Submitted: 1 November 2014  Accepted: 29 July 2015   Published: 28 September 2015

Abstract

Mature minor consent only became available in Australia in 2007. There is neither an explicitly defined protocol, nor a clear definition evident in the literature relating to use of the mature minor concept in health research. Due to difficulties in defining fixed age ranges to varying levels of maturity and vulnerability, there is a lack of clarity surrounding when it might be reasonable and ethical to apply for or grant a waiver for parental consent. This paper describes the challenges faced and solutions created when gaining approval for use of mature minor consent in a respondent-driven sampling (RDS) study to explore the social norms and alcohol consumption among 14–17-year-old adolescents (n = 1012) in the community. The University’s Human Research Ethics Committee granted mature minor consent for this study, and the techniques applied enabled recruitment of adolescents from community-based settings through use of RDS to achieve the required sample. This paper has relevance for research that requires a waiver for parental consent; it presents a case study for assessing mature minors and makes recommendations on how ethical guidelines can be improved to assist human research ethics application processes.

Key words: ethics, health promotion.


References

[1]  National Health and Medical Research Council, Australian Research Council, Australian Vice-Chanvellors’ Committee. National statement on ethical conduct in human research 2007 (updated December 2013). Canberra, ACT: Commonwealth of Australia; 2013.

[2]  Brody JL, Waldron HB (2000) Ethical issues in research on the treatment of adolescent substance abuse disorders. Addict Behav 25, 217–28.
Ethical issues in research on the treatment of adolescent substance abuse disorders.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c3lsV2lsQ%3D%3D&md5=46537df0e75db269dc431ac49b5fdd8fCAS | 10795946PubMed |

[3]  Gallagher M, Haywood SL, Jones MW, Milne S (2010) Negotiating informed consent with children in school-based research: a critical review. Child Soc 24, 471–82.
Negotiating informed consent with children in school-based research: a critical review.Crossref | GoogleScholarGoogle Scholar |

[4]  United Nations. Convention on the rights of the child. 1989. Available from: http://www.ohchr.org/EN/ProfessionalInterest/Pages/CRC.aspx [Verified 27 August 2015].

[5]  Powell MA, Smith AB (2009) Children’s participation rights in research. Childhood 16, 124–42.
Children’s participation rights in research.Crossref | GoogleScholarGoogle Scholar |

[6]  Coyne I (2010) Accessing children as research participants: examining the role of gatekeepers. Child Care Hlth Dev 36, 452–4.
Accessing children as research participants: examining the role of gatekeepers.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3cnotlyksw%3D%3D&md5=1de1ab4fb64370d9b866254d2bd05fb3CAS |

[7]  Campbell A (2008) For their own good: recruiting children for research. Childhood 15, 30–49.
For their own good: recruiting children for research.Crossref | GoogleScholarGoogle Scholar |

[8]  Powell M, Fitzgerald R, Taylor N, Graham A. Ethical issues in undertaking research with children and young people (Literature review for the Childwatch International Research Network). Australia and New Zealand: Southern Cross University, Centre for Children and Young People and University of Otago, Centre for Research on Children and Families; 2012.

[9]  Hunter D, Pierscionek BK (2007) Children, Gillick competency and consent for involvement in research. J Med Ethics 33, 659–62.
Children, Gillick competency and consent for involvement in research.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2snks12rtw%3D%3D&md5=382293fb29e0c6249e062bf90db5d3c7CAS | 17971470PubMed |

[10]  Taylor CG (2008) Counterproductive effects of parental consent in research involving LGBTTIQ youth: international research ethics and a study of a transgender and Two-Spirit community in Canada. J LGBT Youth 5, 34–56.
Counterproductive effects of parental consent in research involving LGBTTIQ youth: international research ethics and a study of a transgender and Two-Spirit community in Canada.Crossref | GoogleScholarGoogle Scholar |

[11]  Sanci LA, Sawyer SM, Weller PJ, Bond LM, Patton GC (2004) Youth health research ethics: time for a mature-minor clause? Med J Australia 180, 336–8.

[12]  Santelli JS, Smith Rogers A, Rosenfeld WD, DuRant RH, Dubler N, Morreale M, et al (2003) Guidelines for adolescent health research: a position paper of the Society for Adolescent Medicine. J Adolescent Health 33, 396–409.

[13]  Kuther TL (2003) Medical decision-making and minors: issues of consent and assent. Adolescence 38, 343–58.

[14]  Schachter D, Kleinman I, Harvey W (2005) Informed consent and adolescents. Can J Psychiat 50, 534–40.

[15]  Levine RJ (1995) Adolescents as research subjects without permission of their parents or guardians: ethical considerations. J Adolescent Health 17, 287–97.
Adolescents as research subjects without permission of their parents or guardians: ethical considerations.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK28vgtFCrsQ%3D%3D&md5=39d7c4daec605cab80661480b7d3762cCAS |

[16]  Haller DM, Sanci LA, Patton GC, Sawyer SM (2005) Letter to the editor. Med J Australia 183, 439

[17]  Santelli JS, Rosenfeld WD, DuRant RH, Dubler N, Morreale M, English A, et al (1995) Guidelines for adolescent health research: a position paper of the Society for Adolescent Medicine. J Adolescent Health 17, 270–6.
Guidelines for adolescent health research: a position paper of the Society for Adolescent Medicine.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK28vgtFCrsw%3D%3D&md5=88be4f13e3661e9cb4ff1676fa58ec57CAS |

[18]  Thomas N, O’Kane C (1998) The ethics of participatory research with children. Child Soc 12, 336–48.
The ethics of participatory research with children.Crossref | GoogleScholarGoogle Scholar |

[19]  Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Social Sciences and Humanities Research Council of Canada. Tri-council policy statement: ethical conduct for research involving humans. 2010. Available from: http://www.pre.ethics.gc.ca/pdf/eng/tcps2/TCPS_2_FINAL_Web.pdf [Verified 11 August 2015].

[20]  US Department of Health and Human Service. Part 46: Protection of human subjects. Washington, DC: US Department of Health and Human Services; 2009.

[21]  Medical Research Council. Medical research involving children. London, UK: Medical Research Council; 2007.

[22]  Carter B (2009) Tick box for child? The ethical positioning of children as vulnerable, researchers as barbarians and reviewers as overly cautious. Int J Nurs Stud 46, 858–64.
Tick box for child? The ethical positioning of children as vulnerable, researchers as barbarians and reviewers as overly cautious.Crossref | GoogleScholarGoogle Scholar | 19215922PubMed |

[23]  Reyna VF, Farley F (2006) Risk and rationality in adolescent decision making: implications for theory, practice, and public policy. Psychol Sci Public Interest 7, 1–44.

[24]  Steinberg L (2013) Does recent research on adolescent brain development inform the mature minor doctrine? J Med Philos 38, 256–7.
Does recent research on adolescent brain development inform the mature minor doctrine?Crossref | GoogleScholarGoogle Scholar | 23607975PubMed |

[25]  Hildebrand J, Maycock B, Burns S, Zhao Y, Allsop S, Howat P, et al (2013) Design of an instrument to measure alcohol-related psychosocial influences in the development of norms among 13-year-old to 17-year-old adolescents. BMJ Open 3, e003571
Design of an instrument to measure alcohol-related psychosocial influences in the development of norms among 13-year-old to 17-year-old adolescents.Crossref | GoogleScholarGoogle Scholar | 23959761PubMed |

[26]  Hildebrand J, Maycock B, Howat P, Burns S, Lobo R, Dhaliwal S (2013) Investigation of alcohol-related social norms among youth aged 14–17 years in Perth, Western Australia: protocol for a respondent-driven sampling study. BMJ Open 3, e003870
Investigation of alcohol-related social norms among youth aged 14–17 years in Perth, Western Australia: protocol for a respondent-driven sampling study.Crossref | GoogleScholarGoogle Scholar | 24154519PubMed |

[27]  Johnston LG, Sabin K (2010) Sampling hard-to-reach populations with respondent driven sampling. Methodol Innov Online 5, 38–48.

[28]  Tigges BB (2003) Parental consent and adolescent risk behavior research. J Nurs Scholarship 35, 283–9.
Parental consent and adolescent risk behavior research.Crossref | GoogleScholarGoogle Scholar |

[29]  Rojas NL, Sherrit L, Harris S, Knight JR (2008) The role of parental consent in adolescent substance use research. J Adolescent Health 42, 192–7.
The role of parental consent in adolescent substance use research.Crossref | GoogleScholarGoogle Scholar |

[30]  Ellickson PL, Hawes JA (1989) An assessment of active versus passive methods for obtaining parental consent. Evaluation Rev 13, 45–55.
An assessment of active versus passive methods for obtaining parental consent.Crossref | GoogleScholarGoogle Scholar |

[31]  Buettner P, Muller R. Epidemiology. South Melbourne, Vic.: Oxford University Press; 2011.

[32]  Willis G (2006) Cognitive interviewing as a tool for improving the informed consent process. J Empir Res Hum Res 1, 9–24.
Cognitive interviewing as a tool for improving the informed consent process.Crossref | GoogleScholarGoogle Scholar |