<P> However , 45 CFR 46 does not specify an exact age at which informed assent must be obtained . Instead , it places responsibility for this determination with hospitals ' own Institutional Review Boards ( IRBs ) . Increasingly , many such IRBs are adopting the ' Rule of Sevens , ' which has formed part of common law for centuries and divides a child 's life into three sections : birth to seven , seven to fourteen , and fourteen to twenty one years old . Before 7 years old children are said to lack the cognitive development necessary for autonomous decision - making . At age 7 years children are considered able to distinguish right from wrong . Adolescents 14 years old and above are legally and socially accountable for their actions . Although not law , meaning physician can choose to ignore it , the rule of sevens is recommended by organizations including the American Academy of Pediatrics and in some areas , such as the state of California , has been written into local law . </P>
<P> However , 45 CFR 46 does not specify an exact age at which informed assent must be obtained . Instead , it places responsibility for this determination with hospitals ' own Institutional Review Boards ( IRBs ) . Increasingly , many such IRBs are adopting the ' Rule of Sevens , ' which has formed part of common law for centuries and divides a child 's life into three sections : birth to seven , seven to fourteen , and fourteen to twenty one years old . Before 7 years old children are said to lack the cognitive development necessary for autonomous decision - making . At age 7 years children are considered able to distinguish right from wrong . Adolescents 14 years old and above are legally and socially accountable for their actions . Although not law , meaning physician can choose to ignore it , the rule of sevens is recommended by organizations including the American Academy of Pediatrics and in some areas , such as the state of California , has been written into local law . </P>
who determines the age of assent at an institution
who determines the age of assent at an institution
hospitals ' own Institutional Review Boards
hospitals ' own Institutional Review Boards