Release date: May 8, 2017
Expiration date: May 31, 2023
Last reviewed: March 9, 2022
Amount of CME credit: 0.75 AMA PRA Category 1 Credit(s)™
Amount of Nursing Contact Hours: 0.75 Contact Hours
Estimated Length of Time for Completion: approximately 0.75 hour

Program Overview

Children's Roles in Medical Decisions explores the three primary ways in which older children and teenagers can influence or control their medical care. It examines the ethics and law of emancipated and mature minors, and describes the ethical and practical challenges of children’s assent.

Target Audience

This continuing education activity has been designed for physicians, nurses, psychosocial clinicians, and others who work with children in medical contexts.

Educational Objectives

By the end of this course, learners will be able to:

  • Define the concepts of an emancipated and mature minor.
  • Describe the implications for medical decision-making when an adolescent is emancipated.
  • Explain how the mature minor doctrine is grounded in state law.
  • Discuss the notion of assent and its application to decision-making in pediatrics.

In this activity, learners will engage with the content by moving through a series of brief video lectures with links to related readings, downloadable resources, and quizzes.

The Structure of the Course

This course is divided into three lectures:

  1. Mature Minors (8:16)
  2. Emancipated Minors (11:26)
  3. Assent (11:36)

Each lecture includes a list of suggested readings that provide more detail about what was discussed. Links to external readings will lead you to an abstract or, if available, the full article.

Successful completion of this educational activity and receipt of certificate of credit includes achieving a minimum score of 80% on the post-test.

Accreditation and Designation of Credit

In support of improving patient care, Penn Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


The Perelman School of Medicine at the University of Pennsylvania is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Perelman School of Medicine at the University of Pennsylvania designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity has been designated by the Perelman School of Medicine at the University of Pennsylvania for 0.75 hours of Patient Safety/Risk Management.


Penn Medicine Nursing is an approved provider of continuing nursing education by the Pennsylvania State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.  Approval # 124-3-H-15.

Penn Medicine Nursing awards this activity 0.75 contact hours.

Physician Assistants

AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 0.75 Category 1 credits for completing this activity.

Meet the Faculty

Steven Joffe, MD, MPH

Steven Joffe, MD, MPH, is the Art and Ilene Penn Professor of Medical Ethics and Health Policy at the University of Pennsylvania Perelman School of Medicine. He serves as interim chair of the Department of Medical Ethics and Health Policy and chief of the Division of Medical Ethics. And he directs two postdoctoral fellowships in biomedical ethics. He is also a professor of Pediatrics at the Perelman School and Children’s Hospital of Philadelphia (CHOP). He attended Harvard College, received his medical degree from the University of California at San Francisco (UCSF), and received his public health degree from UC Berkeley. He trained in pediatrics at UCSF and undertook fellowship training in pediatric hematology/oncology at the Dana-Farber Cancer Institute and Boston Children’s Hospital. Prior to coming to Penn, he served on the faculty of Harvard Medical School, and was an attending pediatric oncologist at the Dana-Farber Cancer Institute and Boston Children’s Hospital, for 13 years. 

Dr. Joffe’s research addresses the many ethical challenges that arise in the conduct of clinical and translational investigation and in genomic medicine, both in pediatric oncology and other areas of medicine and science. He has been the principal investigator (PI) of NIH, Patient-Centered Outcomes Research Institute (PCORI), and foundation-funded studies that examine the roles and responsibilities of PIs in multicenter randomized trials, accountability in the clinical research enterprise, governance of learning activities within learning health care systems, return of individual genetic results to participants in epidemiologic cohort studies, and the integration of genomic sequencing technologies into cancer care. He has also lectured widely on research ethics and on the ethical, legal, and social implications of genomic technologies. He was previously a member of the Department of Health and Human Services Secretary’s Advisory Committee for Human Research Protections, a member of the National Academy of Sciences Committee on Federal Research Regulations and Reporting Requirements, and chair of the Children’s Oncology Group Bioethics Committee. He currently serves as a member of the U.S. Food and Drug Administration’s (FDA) Pediatrics Ethics Subcommittee. 

In his teaching within the department's online educational initiatives, Dr. Joffe aims to convey a deep understanding of the ethical principles underlying research, while guiding students in how to apply those principles to real-world problems. He hopes students will take one core lesson from his teaching: it is possible to conduct studies on questions relevant to policy and practice that are both experimentally rigorous and ethically respectful of the rights and interests of the individuals who take part.

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The following planning committee member has reported the following relevant financial relationships with commercial interests related to the content of this educational activity:

Ezekiel J. Emanuel, MD, PhD: Leigh Bureau, Speaker Honorarium; Oak HC/FT, Salary; Nuna, Stock Shareholder

The faculty and planning committee members listed below have disclosed that they have no relevant financial relationships with any commercial interests related to the content of this educational activity:

Steven Joffe, MD, MPH
Autumn Fiester, PhD
Dominic A. Sisti, PhD
Connie Ulrich, PhD, MSN
Amy Ashbridge, MBA
Adam Zolkover, MA
Laura C. Hart, MFA
Mila Kostic, CHCP, FACEHP
Michael Schoen, PhD
Rodman Campbell, CHCP
Patricia Smith, DNP, RN, BC

The faculty reported that there will be no mention of investigational and/or off-label use of products in this presentation.

Acknowledgment of Commercial Support

There was no commercial support used in the development of this educational activity.


For questions related to this educational activity, contact Penn Medicine Continuing Medical and Interprofessional Education at the Perelman School of Medicine at the University of Pennsylvania at or at 215-898-8005.

If you have questions, please contact Caitlin O'Neill, Program Manager for Online Educational Initiatives, at 215-746-3971 or