The Rights of Hospitalized Children: The Right to Provision, Protection, and Participation

Introduction

In the context of healthcare, several rights of hospitalized children are especially relevant and require specific consideration. At first glance, hospitalization seems to be related to healthcare and the provision of health services to children, but it is important to consider how it is related to other child rights (Lansdown, 2000; United Nations Committee on the Rights of the Child [UNCRC], 2013b). The United Nations Convention on the Rights of the Child (CRC; the Convention) (United Nations [UN], 1989) is the human rights convention of children and has almost universal ratification. With a comprehensive and holistic approach, the rights of children from diverse backgrounds and in multiple contexts are defined in the CRC. The Convention obligates States and adult citizens to implement it in any decision or practice concerning children (Third et al., 2014; van Oudenhoven & Wazir, 2006). This chapter adopts a rights-based approach to the hospitalization of children and uses the CRC as the primary background to discuss the rights of hospitalized children. As such, the chapter begins by introducing the key features, unique aspects, and major principles of the CRC. This is followed by a discussion of the specific rights that are most relevant in the case of hospitalized children. This discussion begins with two specific articles that also constitute two of the major principles of the Convention—“the best interests of the child” and “the right of the child to be heard”. Then, children’s right to play, which is related to the main theme of the present book, is examined. The rights-based issues associated with the provision of high-quality healthcare services for children are examined in each of the sections on specific rights.

CRC rights are not defined hierarchically; they are inseparable and all have equal value and emphasis. Moreover, it is a systematic whole that is evidence-based. Thus, a specific right cannot be prioritized over any other and should always be considered in relation to the other rights in the Convention (Lansdown, 2000; UNCRC, 2013a). This chapter addresses the interrelationships between child rights in the case of hospitalized children.

According to the CRC, anyone under the age of 18 years is considered a child. This age group encompasses multiple developmental periods; therefore, the discussion of children’s rights is relevant to both younger and older children, and adolescents (Lansdown, 2005). The implementation of child rights should consider these developmental differences. In this chapter the developmental aspects of recognizing, protecting, and fulfilling the rights of children—especially very young children and adolescents—are indicated whenever necessary. The major theme of the present book, Play Specialism, is also discussed in relation to the rights-sensitive approach it encompasses.

The last two parts of this chapter are devoted to some of the rights-based issues regarding recent developments in information and communication technologies, and the widespread use of digital media. Digital environments offer new opportunities for children. The associated risks and opportunities depend on how they are used (Lievens et al., 2019; Livingstone et al., 2016, 2017). Another topic highlighted in the chapter is how digital tools and environments can be used to support hospitalized children’s rights to education, play, and participation. Finally, In My Shoes (IMS), a computer-assisted interview technique that helps children communicate the details of their life and experiences is explained (Calam, Cox et al., 2000; Grasso et al., 2013). Improving the quality of healthcare services for hospitalized children and fulfilling their right to participation in particular require the use of methods that are appropriate for their age and developmental level. These methods should be child-friendly and facilitate communication between children and trained professionals. This is especially important for children that have difficulty communicating due to very young age or disability (Christensen, 2004; Clark, 2005; Clavering & McLaughlin, 2010). IMS was designed as an interviewing tool for facilitating communication between trained interviewers and children—even with very young children, which helps children to express their emotions, experiences, and opinions (Calam, Cox et al., 2000; Fängström & Eriksson, 2020; Grasso et al., 2013). IMS can provide opportunities for children to share their experiences related to hospitalization and to talk about the quality of the healthcare they receive. The last two topics in the chapter are briefly examined in terms of their relevance to Play Specialism interventions.