This approach suggests that the content and process of child assent should be allowed to vary across development.
As the Polish part of the GABRIEL case, followed by the study by van der Pal et al., gives limited data, we would like to avoid overgeneralisation regarding the actual process of obtaining assent in paediatric research.
4 Under these circumstances, unless the patient has the capacity to provide consent, we will adopt a process of deferred assent where the research blood sample is taken as part of routine care and permission sought from the consultee or the Independent Mental Capacity Advocate at each recruitment site for inclusion into the study.
The processes of obtaining assent or consent from adolescents may vary per context and country.
The content and the process of decision making in assent should thus be adjusted to the individual child [ 14- 16].
There is a general growing tendency in favour of personalisation of the process of assessment of the age of assent, i.e. suggesting that it should be tailored to a particular child.
All clinicians are trained in the study processes of obtaining consent, assent (for children aged 11 and over) and completing the baseline data collection form known as the case report form (CRF).
Rather, when feasible, environmental investigators can strive to create a goodness of fit between children's maturing skills and the research context by approaching child assent as a process of research education fitted to the child's age and abilities (Fisher 2002, 2003a).
In such situation the decision should be made by the relevant decision-maker but complemented by the seeking of assent from the child, where assent is understood as a process of respectful and sensitive engagement and involvement.
But the process needs the assent of Ukraine's government, which is why the recent hasty vote was a violation of international law.
