informed consent, ethics and children

[Julie Rosof <rosof@xxxxxxxxxxxxxxxxxxxxx>]

I am a grad student in public policy and a sexual assault nurse examiner
who is in the midst of an ethics class and looking into the topic of
informed consent in the context of medical legal evaluations for
allegations of child sexual abuse.  More specifically, I am interested in
the ethical and legal issues surrounding the evaluation of children up to
the age of 18 years in the outpatient setting. 

While there are state and federal laws that guide evaluators, I am
interested in exploring the "gray areas" surrounding the examination,
photography (e.g. documentation of genital injury), interviewing a child
for medical history, testing for sexually transmitted diseases(including
HIV testing) treatment (e.g. pregnancy prophylaxis)- to just name a few
potential topics. For example, what are the ethical/legal issues
surrounding a 7 yo refusing a medical-legal examination?  What are the
ethical/legal issues if a 15 yo refuses an examination?

I would appreciate any guidance and references that address legal issues
(e.g. informed consent, assent, and competency) and ethical issues (e.g. do
no harm, promote health/well being) in evaluation of child abuse
allegations from any perspective- including psychology, social work,
nursing, medicine, law enforcement, and child protection services.  I
realize the distinction between legal and ethical issues may be blurred in
many circumstances.

Thank you.

Julie Rosof, RN, MSN
Vanderbilt Institute for Public Policy Studies
Center for Mental Health Policy
1208 18 th Ave South
Nashville TN 37232
(615) 343-1654
Email Rosof@uansv5.vanderbilt.edu