Children’s Rights to Participate in Decision-Making: Insights from Islamic Teachings

Barriers: Poor quality information, parents and child’s emotional state, power imbalance (children excluded), insufficient time.

Facilitators: High quality information, agreement or desired for SDM, trust and respect, access to SDM tools and resources.

Child express doubt about SDM utility and preferred to avoid the burden of decision-making.

HCP and parents also assume that younger children were unable to participate in SDM and HCP claimed that children could not properly understand the medical information needed to engage in decision-making.

Invitation to participate in decision-making should be supported with information that is consistent with child’s developmental stage (assess their health literacy level and tailored it accordingly using child-friendly and appropriate information).

Three themes were discovered: Lived experiences with participation in decision-making, children’s perception of body and self in comparison to peers and children’s lived experiences of the power relationship with therapist.

Children either accept or feel satisfied with their limited participation in decision-making due to gratitude (trusting the therapist’s knowledge), uncertainty about their input, or silent goal-setting without assurance of being heard.

They preferred to take part in smaller decision like informing when hurt or taking a break.

Children’s voice is acknowledging their perspective and attending to their feelings, belief, preferences and thoughts.

If excluded their view, they will also lose sense of belonging, autonomy and self-regulation.

Challenges: Macro policy agenda, difficulty in recognising and understanding children’s modes and purpose of communication and adult may misinterpreted the child’s action.

Adults and children should actively engage in a meaningful, two-way interaction where they learn from and influence each other while maintaining mutual respect and understanding.

Adult also need to have advanced knowledge regarding child development and spend sufficient time to build trust and understanding.

Steps to engage: Understand children’s voice, listen actively, advocate effectively for the children and mediate macro policies.

Participation: Right of children to express their views and have them acted upon appropriately.

Strong evidence supports the effectiveness of advocates in enabling children’s participation, helping them express views and influence decision.

Children who attend meetings are more likely to participate in decision-making but might be hindered by meeting dynamics and relationship with social workers.

Family welfare conferences can facilitate participation but their opinion might not influence the decisions.

Documenting children’s view is essential but it often fails to capture the authentic perspectives.

Conducive environment and trust for the caseworkers are essential for the children’s participation.

Respecting CYP’s views and ensuring meaningful adult conversations are crucial. Ethical frameworks emphasize the importance of agency, competency, and avoiding tokenism.

Healthcare services need to be child-centred, ensuring accessibility and equity. CYP’s input is essential for improving service design and delivery.

Effective communication and age-appropriate information are vital for CYP to understand their role in healthcare discussions.

CYP should be empowered to participate in decision-making, with their perspectives valued alongside adult views.

Barriers: Adult’s perception toward CYP’s agency and competency, communication challenges, lack of resources and historical views of CYP as dependent

A child’s voice is shaped by their relationships with others and the specific context in which they express themselves. It does not come from a single source, meaning it can have different meanings based on the situation. A child’s voice is often created through conversations between different generations, and we should not overlook the factors that influence these interactions.

Reflexivity involves recognizing the power dynamics at play in the researcher-child relationship. Researchers need to consider how their position as adults can affect what children feel comfortable expressing and how their voices are interpreted.

While the intention to highlight children’s voices is positive, it can lead to oversimplified representations of their experiences, as researchers may take these voices at face value without considering the complexities involved.

Quran and Hadith emphasized right of children in Islam (in education, protection and health).

“Walayāh”: The concept of parental authority and responsibility towards children’s well-being.

Gender equality in children’s right: Prophet Muhammad emphasize equal treatment for both genders

Emphasizes parental responsibility and the right of youth to participate in decision-making.

Encourages fair inheritance and wealth distribution to prevent economic disparities.

Challenges: Differences in interpretation of Islamic teachings lead to variations in implementation across Muslim societies, cultural and traditional practices conflict, gender inequality, social and economic barriers and contemporary challenges (globalization & technology).

How to encourage: Islamic foundation, family-level participation, education as tool and healthcare providers to adopt with participatory approaches.

Taking child’s assent in paediatric research is considered as a form of justice.

Children vary in age with regard to when they develop competency and capacity and they are constantly maturing mentally and emotionally which could affect their decision from time to time. The complexity of scientific and technical information provided to a child during the assent process can affect his/her understanding, although efforts should be made to deliver it in simple language.

Challenge: Knowledge barriers, cultural perceptions and uncertainties regarding religious judgements.

Hadhanah (child custody) applies to children who are not yet mummayiz and still require supervision and support.

Mummayiz children, on the other hand, have the right to express their views on custody matters. The right of custody for mummayiz children is known as Kafalah which allow them to choose which parent to live with after a divorce.

While courts do listen to the wishes of minors, their primary concern is always the child’s best interest and overall welfare.

If the child has no issue in choosing, court will make the decision by considering the maslahah and welfare of the child.

Under Section 84 (1) of the Islamic Family Law (Federal Territory) Act 1984 (IFLA), “The right of Hadhanah terminate when the child attaining the age of seven for male and nine years for female but courts may, upon application allow to retain the custody for the child until nine for male and eleven years old for female”.

Section 84 (2), “After the termination, if the child reached mummayiz, he or she shall have the choice to live with either parents unless court’s order otherwise”.

Child is called to the court for their opinion but there are no specific guidelines for the age which child should be brought to participate in proceedings. Meanwhile for sulh, the children are not called as the parents will only negotiates and disputes.

It is argued that the child’s feedback is not final but serves as a basis for the parents to reach an amicable settlement. The child’s views also help the judge approve the agreement. However, the judge can choose not to accept the child’s opinion if it conflicts with the child’s welfare.

The challenge lies in the differing practices across states regarding children’s participation in Hadhanah cases.

4 main theoretical perspectives: Legal (children’s right to be heard), sociological (children as active agents), democratic (participation as a civic right) and involvement (participation as engagement activities).

Barriers: Lack of awareness, adult being sceptical about children’s abilities, traditional hierarchy and limited opportunities.

Teacher’s role: Use their influence to encourage to participate, pedagogical sensitivity (respect, attention and trust) and teachers should receive training to improve engagement.

More studies on the teacher’s perspective compared to children.

Benefit: Enhance self-regulation, problem solving and autonomy, improve wellbeing and self-belonging and contributes to social and cognitive development.

Children’s active participation varied and was seen most evident at levels four and five and the participation was both optimal and nonoptimal.

Children communicate through verbal and nonverbal cues. Nonverbal cues include curious gazes, contemplation, crying, head shaking, shoulder shrugging, withdrawing from healthcare providers or parents to show refusal, nodding for acceptance, murmuring, smiling, laughing, and various facial expressions.

Children learn the nuances of a situation through observation and apply their past experiences when similar situations occur again. Negative events may cause withdrawal, while positive events can foster motivation and engagement.

Child refusal should be taken seriously, and children should be regarded as rational and competent in their own way.

Active involvement of children in their healthcare decisions leads to better outcomes, including reduced anxiety and improved recovery.

The first two themes that emerged on children’s view are enthusiasm and competency.

Children expressed their willingness to participate in decision-making process for their city as they have positive experience of involving at school. They not only show positive reactions but also providing suggestion how their idea can be integrated.

They expressed their opinion as they considered themselves as part of the society and have the right to participate

Children express their opinions and view themselves as active members of society with the right to participate, as demonstrated through their preference for inclusion in decision-making and the student election process, where they believe every member has the right to vote.

They wish to contribute to society, gain experience, and challenge the inadequacy of adult perspectives by providing examples and supporting child inclusion.

While offering suggestions to enhance their participation, they acknowledge that societal perceptions of childhood impose restrictions on their right to engage fully in civic life.

Maqasid al-shari’ah can be defined as the purpose or objective of shari’ah,

Main objective of shari’ah is to establish mercy and justice while diminishing the prejudice and injustice in the society.

Children’s rights, particularly their right to health, must be recognized, and parents should not neglect, abandon, or refuse to provide them with proper medical care.

The concept of Maslahah (public interest) emphasizes that children’s best interests should be prioritized.

Article 12 requires states to ensure children’s views are heard in all matters affecting them, including care proceeding

In court cases, children’s opinions are frequently overlooked in the decision-making process. When they are included, their views are usually conveyed through a representative and are primarily used to support their care plan and adjustments, rather than being directly taken into account

Barriers: Age and capacity assumptions (adult underestimate children’s ability), fear and distrust, lack of support and adult-filtering (child’s opinion usually mediated through adults first)

Suggestions: Child-focused approach (creative tools), professional training (for the judge, lawyers or social workers), independent advocacy (to support children), cultural reforms and accountability (courts to review children’s opinion)

Meaningful participation involves building trust, addressing power imbalances in decision-making and prioritize cultural responsiveness and child-centred practices

SDM in paediatrics is poorly defined and there is no clear roles of the paediatric patient and their parents.

Most of the interventions focused more on the parents rather than the children.

Children have the ability to express their opinions, but their involvement is determined by their level of maturity. While including them may be a new concept in society, it is vital for improving decision-making.

Parents and provider should utilize judgement and empathy while making decision with children.

This project serves as an intervention to encourage young people to engage in decision-making, functioning as a pitch day where they can present their ideas for real-world implementation.

The ReSPECT Approach utilizes the model of ’Discuss, Discover, Design, and Advocate’ to promote participation in decision-making.

Challenges for the programme: Institutional funding, required long-term engagement and ethical issue.

Islam emphasizes the right for children; social right, educational right and financial right.

Role of parents: Ensure children’s right are fulfilled.

Role of state: Establish laws protecting children’s right, create child-friendly education and welfare programs and enforce law against child abuse.

Role of society: Raise awareness of children’s right, monitor government policies and provide child-friendly schools and social programs.

CRC principle of participation emphasizes on children right to express their views on the decision that affecting them.

Ibn Sina’s view on education, which promotes social interaction, discourse, and participation, aligns with the idea of children having a say in their learning and environment.

In Islam, the dominance of adults in decision-making, which limits children’s participation, may be attributed to the respect for authority and elders.

Listening should go beyond hearing but involve valuing the children’s perspective.

Concept of Shura (mutual consultation) encourage for listening to children in decision-making.

Children communicate in many ways beyond verbal speech including plays and storytelling.

Islamic teaching promotes Ihsan (fairness) which should be applied and include the child as it would be fair to include them since the decision is about them.

While adults often act as gatekeepers of children’s voices, Islam emphasizes tarbiya (moral upbringing), where parents are guides rather than dictators.

The are three approaches taken by the judge to children’s participation in Hadhanah proceedings:

1. Children are called and views are taken leads to their choice accepted.

2. Children are given opportunity to attend court and given right to speak but opinions rejected.

3. Children are not called even they are mummayiz.

Emotional stability of the children is not addressed or considered during the questioning and there is no presence of child counsellor involved in the court for proceedings.

The study highlighted the absence of specific guidelines for judges on how to appropriately question children and assess their emotional welfare during custody proceedings.