Figure 1

Decision tree guide regarding parental permission in research with adolescents*. * Numbers in circles enable the reader of the text to follow the explanation on this figure. (a) Harm is an objective measure related to the risk of disclosure of the information obtained in the study. Anonymous studies or studies adhered to standards of data security are usually considered to be minimal risk. However, information could promote risky behaviors depending on the age of the adolescents and/or their level of maturity. (b) When the legal autonomy of adolescents or a particular research topic is controversial, the level of discomfort related to the research should be assessed. (c) A variety of alternatives can be used, such as passive parental consent, permission from a surrogate parent or child’s advocate, and consultation with key school/community members. (d) Extreme cases, such as neglected or abused children, where risks could be exacerbated if parents know the participation of the adolescent. (e) For example, the school board may consider that, due to the nature of some information included in the questionnaire or the aim of the research, it could be inappropriate to leave the decision making in the hands of the school rather than the parents. (f) This question refers to the context of the research. Adolescents in the school are always under the guardianship of their parents and they are easily accessible (9) but this situation is less clear in community-based research or in the Internet (10).