Clinical ethics for the treatment of children and adolescents: a guide for general psychiatrists.
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Clinical work--psychotherapy, assessment, consultation, or research--with emotionally ill children and adolescents is challenging, complex, and exceedingly rewarding. Psychiatrists must remain mindful of children's vulnerabilities but also remain respectful of their rights, regardless of any legal barriers or developmental limitations that exist. To varying degrees, youths are afforded the rights of integrity, autonomy, informed consent or assent, protection of health care information, and participation in research. All physicians who work with children and adolescents are obliged to possess the requisite skills necessary for the provision of beneficial assessments, psychotherapy and psychopharmacology, the protection and advocacy that vulnerable children may require, and the ability to collaborate with families, schools, and other systems in which children regularly function. This work requires self-examination and awareness of one's values and attitudes about children and families and self-monitoring of one's motivations and intents during therapeutic interactions. Additionally, psychiatrists are reminded to seek consultation from valued colleagues whenever an ethical quandary presents itself. Finally, while negotiating the multiple requirements of children, families, communities, legal statutes, and professional ethics and standards, psychiatrists must maintain an ardent commitment to the safety and well-being of their young patients.