Background Adolescents are a unique population with significant unmet health needs. They are often excluded from research that may benefit them as they are perceived as vulnerable and needing protection from research participation. For Research Ethics Committees, conflicting positions in statutes, regulations and ethical guidelines about who provides informed consent for adolescent involvement in health research can be a significant barrier to approving adolescent research. For researchers, the requirement for parental/guardian proxy consent or prolonged approval processes may potentially result in the exclusion of those adolescents most vulnerable and at risk, particularly if issues such as gender-based violence, gender identity, sexuality and sexual practices are in question. Objectives To describe the challenges to adolescent research and suggest strategies to address these. Method We consider the legal and ethical framework in South Africa regarding the consenting age for adolescents in research, outline the challenges and, using examples of best practices, suggest strategies to address the current conundrum. Results We suggest three principles to guide Research Ethics Committees on their approach to reviewing health research involving adolescents. Strategies to develop ethically acceptable approaches to adolescent research and consent processes are described, which include community involvement. We elaborate on examples of nuanced approaches to adolescent research. Conclusion The inclusion of adolescents in research is critical in informing appropriate and effective health services for this vulnerable population, whilst providing an opportunity to link them into care and services where relevant.

中文翻译：

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南非青少年研究的伦理可接受的同意方法。

背景 青少年是一个独特的人群，其健康需求显着未得到满足。他们经常被排除在可能使他们受益的研究之外，因为他们被认为是脆弱的，需要保护他们免受研究参与。对于研究伦理委员会来说，关于谁为青少年参与健康研究提供知情同意的法规、法规和伦理指南中的相互矛盾的立场可能是批准青少年研究的重大障碍。对于研究人员而言，要求父母/监护人代理同意或延长批准程序可能会导致那些最脆弱和最危险的青少年被排除在外，尤其是在基于性别的暴力、性别认同、性行为和性行为等问题存在疑问的情况下. 目标 描述青少年研究面临的挑战并提出解决这些挑战的策略。方法 我们考虑了南非关于研究中青少年同意年龄的法律和伦理框架，概述了挑战，并使用最佳实践的例子，提出了解决当前难题的策略。结果 我们提出了三项原则来指导研究伦理委员会审查涉及青少年的健康研究的方法。描述了制定青少年研究和同意过程的伦理可接受方法的策略，其中包括社区参与。我们详细阐述了青少年研究的细致入微的方法的例子。