children

Children play

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In 2016, the American Academy of Pediatrics revised their policy statement on Informed Consent in Decision-making in Pediatric Practice. This third and updated revision was published in Pediatrics, August 2016 Volume 138, Issue 2.

Those interested can refer to this link – http://pediatrics.aappublications.org/content/138/2/e20161484. It is a good read and reference, especially at a time where the issue of decreasing the age from 15 to 9 years old for criminal liability in the country is being discussed.

This short article is a personal opinion and hopefully sheds light surrounding issues on why lawmakers need to hear the other side of the coin.

So why begin this post with informed permission prior to a medical intervention? The argument is simple. If you need consent from parents and legal guardians over simple medical procedures or interventions for pediatric patients, why make a child as young as 9 years old be held accountable for a criminal activity which he may or may not be a willing participant in? The second question that should be asked is – what is the basis for the cut-off age of 9 (and then shifting to 12) as the “responsible” age for any liability?

The background for securing informed consent in medical practice for children stems from the conceptual difficulties encountered “in trying to apply the framework of informed consent in the pediatric setting”, in which most “patients either lack the ability to act independently or have limited or no capacity for medical decision-making.” If children are unable to decide on what is good or bad for their health, how can we make them criminally liable for a crime they may not even be fully aware of but participate in?

Pediatric patients are unique. I am sure we all can agree on that. “Developmental maturation of the child allows for increasing longitudinal inclusion of the child’s opinion in the decision-making process. Encouraging pediatric patients to actively explore options and to take on a greater role in their health care may promote empowerment and compliance with a treatment plan.”

“Adolescent decision-making is dependent on several factors, including cognitive ability, maturity of judgment, and moral authority, which may not all proceed to maturation along the same timeline. Many minors reach the formal operational stage of cognitive development that allows abstract thinking and the ability to handle complex tasks by mid adolescence. Brain remodelling with enhanced connectivity generally proceeds through the third decade of life, with the prefrontal cortex, the site of executive functions and impulse control, among the last to mature. In contrast, the risk-taking and sensation-seeking areas (limbic and paralimbic regions) develop around puberty. This temporal imbalance or “gap” between the 2 systems can lead to the risky behaviour seen in adolescence.”

http://pediatrics.aappublications.org/content/138/2

This alone should make one understand the differences on how the adolescent reacts to various environmental influences for his or her behaviour. A perfect example is on how those who finish college at much earlier age, are socially and mentally immature for their age when they begin to work. Or social responsibility of adolescents who are already parents. How does a 12 year old father give consent for his newborn son who is set to undergo a complicated surgical procedure? Or a 10 year old mother who has to decide on end of life support for her premature baby? “There is clearly a paradox encountered when adolescents are allowed to make complex medical decision for their child but cannot legally direct their own medical care.”

Because parents are generally recognised as the “appropriate ethical and legal surrogate medical decision-makers for their children and adolescents”, the parents AND NOT THE CHILD should be held fully accountable for any legal liability of their children. Punishing the child is not the right frame of thought. The children’s interests should be the onus of the parents and not the other way around.

Children grow up based on the environment of their upbringing. Like sponges, a child’s brain absorbs everything. Raise them in a family of thieves and they have a higher chance of turning to the wrong side of the law. For those who are poor, they learn to survive even if it means they have to make ends meet just to feed their hungry stomachs. Those who have more in life are lucky. Life is kinder to them.

You remember when you were 9 years old? Those were happy memories. It was all about school and play. That was what we were busying ourselves with. I’m sure, most of you reading this post have similar memorable experiences. Those were the best days of our relative joys in life. Other children – those raised in conflict zones, those who are used and abused because of social conditions – their stories will always be a different one.

Parents will always have that responsibility and accountability in the lives of their children. How they mold them will always be their role. And that’s who we need to target – that final liability.

We start them young

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Are cartoons good entertainment for children?

While seemingly unharmful, cartoons may apparently have its downside, especially when the adults don’t actually screen carefully the contents of what their children watch. The so-called presumption that a “cartoon” is just a figure of imagination may actually be portrayed differently by the young mind.

Not all cartoons are appropriate for age. There are those whose languages and behavior are left for adult viewing. (As a matter of fact, even pegged to be farcical sarcasm takes on politics or life in general, the adult-themed cartoons carry heavy parental guidance or for adults only restrictions.)

Bob’s Burger, Family Guy, The Simpson’s (and a lot more lately on Netflix) are examples of cartoons that are not suitable for young children.

As parents or caregivers, we need to screen what the kids are watching. Just because it’s a “kids” show and that it sells a lot of “kids toys” does not mean that the show is appropriate for a young audience. (I have a lot of “adult” friends who collect various paraphernalia from Funko Pop to Marvel heroes to Anime, as a collectors item). Even the harmless LEGO has become a “toy” for collection and interior design.

And not just because it’s rated aired in a family channel, the contents are appropriate for ALL children regardless of age group.

There’s a reason why the American Academy of Pediatrics has updated in the Fall of 2016 their recommendation of the use of digital media in children. It includes not only how much time, but why, how, when and where it is appreciate to use.

For children 2-5 years old, media should be limited to 1 hour a day and involve high quality programming or something the parents and child can view together.

Except for video chatting, those less than 1 1/2 years old, should avoid any form of digital media.

I get the fact that we all want a little “me time”. After all, it is a handful having to handle one (or a bunch of) rambunctious toddler who’s beginning to explore the world.

In this world where we need to juggle career and family, I applaud parents who take raising a family built on personal supervision as a priority. When you place some of your priorities in the backseat, and care for the overall welfare of your kids more, we start teaching them to discern right from wrong while they’re young.

The British cartoon Peppa Pig is a classic example of an ambiguous cartoon disguised as harmless. Let’s look at it from the angle of what message it sends to a young child.

There’s fat shaming. Yes Peppa repeatedly fat shames her daddy. And the father isn’t much of a role model because he allows Peppa to call him names. Really! Allowing your child to get away cursively at fat shaming you takes the cake at saying, “it’s alright”! And Peppa talks back a mouthful too. Just like the child actress Raissa in the local noontime show on Eat Bulaga, kids think that it’s okay to be “astig” and answer back “wittingly” with adults.

We need to remember that children absorb a show different from adults. While we may find it funny, our entertainment is their learning process. Their brains are like sponges. At that age, they absorb anything and everything. That’s why they try to get their way while they’re growing up. Who they are today, is because we let them.

Solid research demonstrates that in children more than 3 years old, high quality programs like Sesame Street, that teach new ideas are advisable.

Early childhood is a time of rapid brain development, and kids need to balance sleep, learning and playing, and emotional and relationship building. Too much time spent on digital media curtails these other learning processes.

The next time you think that it’s okay to just switch on a seemingly harmless show, I suggest you sit down and watch them with your child.

Discernment, after all, is a virtue.

After all, we shape and mold these young minds from the get go. What they become tomorrow, is how we raise them today.

The prayer

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A father was tucking his 3 years old daughter into bed, told her a story, and listened to her prayers which ended by saying, “God bless mommy, God bless daddy, God bless grandma and goodbye grandpa.”

The father asked, “why did you say goodbye grandpa?”

The little girl replied, “I don’t know daddy. It just seemed like the thing to do.” The next day, the grandpa died. The father thought that it was just a coincidence.

A few months later, while the father was tucking his daughter to bed, and while listening to her nightly prayers, he heard her pray, “God bless mommy, God bless daddy and goodbye grandma.” The next day the grandmother died.

“Holy crap”, thought the father. “my daughter is in contact with the other side.”

Several weeks later when the girl was going to bed, he heard her prayer, “God bless mommy and goodbye daddy.”

He practically went into shock. He couldn’t sleep all night. He got up at the break of dawn to go to his office. He was nervous as a cat all day, had lunch and watched the clock. He figured if he could get by until midnight he would be okay. He felt safe in the office, so instead of going home at the end of the day, he stayed there drinking coffee, looking at his watch and jumping at every sound. Finally midnight arrived. He breathed a sigh of relief and went home.

When he got home, his wife said, “I’ve never seen you work so late. What’s the matter?”

He said, “I don’t want to talk about it. I just had the worst day of my life.”

She said, “You think you had a bad day? You’ll never believe what happened to me. This morning the mailman dropped dead on our porch.”

The confession

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A woman takes a lover home during the day while her husband is at work.

Her 9 year old son comes home unexpectedly, sees them and hides in the bedroom closet to watch.

The woman’s husband suddenly comes home. She puts her lover in the closet not realizing that her son is in there.

Boy: It’s dark in here.

Man: Yes it is.

Boy: I have a baseball…

Man: That’s nice.

Boy: Want to buy it?

Man: No thanks

Boy: My dad’s outside.

Man: Okay, how much is it?

Boy: $250

In the next few weeks, it happens a again. The boy and the lover are in the closet again!

Boy: Dark in here!

Man: Yes it is!

Boy: I have a baseball glove.

The lover, remembering the last time they were in the closet together, knew what the boy was going to say next.

Man: How much?

Boy: $750

Man: Sold!

A few days later, the dad says to the boy to “grab his gloves, go outside and play some catch”.

Boy: I can’t. I sold my baseball and my glove.

Dad: How much did you sell it for?

Boy: $1,000

Dad: That’s terrible to over charge your friends like that…that is way more than those two things cost. I’m taking you to church. Go to confession.”

They go to the church and the dad makes the little boy sit in the confessional booth and closes the door.

Boy: Dark in here.

Priest: Don’t start that shit again. You’re in my closet now.

The birthday wish

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Little Carol came into the kitchen where her mother was making dinner.  Her birthday was coming up and she though this was a good time to tell her mother what she wanted. “Mom, I want a bike for my birthday.”

But Little Carol was a bit of a troublemaker.  She had gotten into trouble at school and at home.  Carol’s mom asked her if she thought she deserved to get a bike for her birthday.  Little Carol, of course (as any little child would), thought she did!

Carol’s mom, being a Catholic, wanted her to reflect on,  her behaviour over the last year.  She told Little Carol to write a letter to God and tell Him why she deserved a bike for her birthday.  Little Carol frowned and stomped up the steps to her room, sat down, and began to write a letter to God.

LETTER 1:

Dear God,

I’ve been a very good little girl this year and I would like a bike for my birthday.  I want a red one.

Your friend,

Carol

But Carol knew this wasn’t true.  She had not been a very good girl this year.  So she tore up the letter and started over.

LETTER 2:

Dear God,

This is your friend Carol  I have been a pretty good girl this year, and I would like a red bike for my birthday.

Thank you,

Carol

Carol knew this wasn’t true either.  She tore up the letter and started again.

LETTER 3:

Dear God,

I know I haven’t been a good girl this year.  I am very sorry.  I will be a good girl if you just send me a red bike for my birthday.

Thank you,

Carol

Carol knew, even if it was true, this letter wasn’t going to get her a bike.  By now, she was very upset and angry.  She went downstairs and told her mother she was going to the nearby church.  Carol’s mom thought her plan had worked because Carol looked pretty sad.

“Just be home in time for dinner”, her mom said.

Carol walked down the street to the church and up to the altar.  She looked around to see if anyone was there.  She picked up a statue of the Virgin Mary, slipped it under her jacked with her rickety bulky body running out of the church, down the street, into her house and up her room.  Panting, she shut the door and sat down and wrote her letter to God.

Letter 4:

I GOT YOUR MAMA. IF YOU WANTT TO SEE HER AGAIN, SEND THE BIKE!

Signed,

YOU KNOW WHO