Asking Adolescents: Does a Mature Minor Have a Right to Participate in Health Care Decisions

Many children approaching the age of majority struggle with severe and sometimes terminal illnesses. Does such a minor possess a Fourteenth Amendment Due Process right to participate in medical decisions concerning her care, or is her fate left solely in the hands of her parents and the State? This Note examines the health care rights of minors and attempts to give a voice to children, a vast, silent population in this country, in the medical care context. After examining such fundamental cases as Belotti v. Baird, this Note finds numerous exceptions, crafted by the courts over several decades in a variety of contexts, to parental autonomy over minors. This Note uses those exceptions as a springboard for determining when a minor\u27s wishes may prevail over those of her parents and the State in health care decisions. Ultimately, this Note concludes that there is room for a minor\u27s voice in the medical care context. To assist courts in determining when a °minor may exercise her Fourteenth Amendment liberty interest in making her own health care decisions, this Note proposes a decisional tree that considers the treatment\u27s effectiveness, the minor\u27s chance of survival with or without the treatment, the potential effects of the treatment, and the minor\u27s competence to make health care decisions. Finally, this Note applies the test to three real life situations

Do adolescent patients have a right to be informed about fertility preservation options by virtue of the Conventions on the Rights of the Child?

The 1989 United Nations Convention on the Rights of the Child not only states that children should be heard in matters of their concern according to their age and maturity, but also that children should have a right to have access to information. However, when it comes to medical indications, a consensus has not been reached on whether parents should disclose healthcare complications to their adolescent child. Adolescent disclosure becomes even more controversial when related to non-lifesaving procedures. In the United States, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the likelihood of survival has dramatically improved. However, cancer treatments, such as chemotherapy and radiation, are likely to affect their fertility later in their lives. Preventive medicine offers procedures to prevent this issue. Yet, if parents decline either disclosure or discussions, adolescent patients will have this possibility denied. As demonstrated by articles that have shown the impact of infertility on sexual well-being and happiness in adults, these patients may experience depression, anxiety, and lower self-esteem at a higher rate. By virtue of Article 17 of the Convention on the Rights of the Child, this essay aims to investigate if adolescents have a right to obtain information, not only through mass media, but also from their parents when disclosure “aims at the promotion of his or her social, […] well-being and physical and mental health” and if being informed is within their best interest taking into consideration their age and maturity

Competent children?: minors’ consent to health care treatment and research

This paper concentrates on controversies about children's consent, and reviews how children's changing status as competent decision makers about healthcare and research has gradually gained greater respect. Criteria for competence have moved from age towards individual children's experience and understanding. Uncertain and shifting concepts of competence and its identification with adulthood and childhood are examined, together with levels of decision-making and models for assessing children's competence. Risks and uncertainties, methods of calculating the frequency and severity of risks, the concept of 'therapeutic research' and problems of expanding consent beyond its remit are considered. The paper ends by considering how strengths and limitations in children's status and capacities to consent can be mirrored in researchers' and practitioners' own status and capacities. Examples are drawn from empirical research studies about decision-making in healthcare and research involving children in the UK

Do Not Resuscitate Decision-Making: Ohio\u27s Do Not Resuscitate Law Should Be Amended to Include a Mature Minor\u27s Right to Initiate a DNR Order

Part One discusses Ohio\u27s current DNR (Do Not Resuscitate) law, which does not include an exception for mature minors. It explains the medical difference between initiating a valid DNR order and refusing life-sustaining medical treatment. However, the note solely focuses on DNR and how it relates to a minor\u27s right to initiate his or her own DNR order in light of parental disagreement. Part two explains the evolution of the minor and healthcare. Specifically, the progression from the early common law assumption that minors lack the capacity to consent, to the present, in which minors are permitted to make some medical treatment decisions without parental consent or knowledge. Part three examines the development of the mature minor exception, and the effect it has had on minor\u27s healthcare rights. This section will also discuss three cases that have applied a mature minor exception in determining whether a minor was capable of consenting to some form of medical treatment. Part four compares West Virginia and New York\u27s DNR statutes to Ohio\u27s current law, and ultimately determines that Ohio\u27s law should be amended to permit mature minor\u27s to initiate a DNR order with or without parental consent. Part five will focus specifically on Ohio\u27s abortion statute, which recognizes a mature minor\u27s right to have an abortion without parental consent or knowledge. It will include an overview of Ohio\u27s abortion law, and an explanation of the judicial bypass proceeding for a mature minor who does not wish to notify her parents. The section will also discuss the mature minor exception as it was applied in the abortion cases of Bellotti v. Baird, Ohio v. Akron Ctr. for Reproductive Health, In re Jane Doe I, and In re Jane Doe. It will conclude that Ohio law should apply the mature minor exception to the area of DNR because it already applies in the significant medical situation of abortion

Gillick and the Consent of Minors: Contraceptive Advice and Treatment in New Zealand

The English House of Lords decision in Gillick has dominated the issue of minor capacity to consent for the last 25 years, but the decision has raised more issues and ambiguities than it hoped to solve.  The speeches in Gillick, although extrapolated to general issues of minor consent, were made in the context of contraception advice and treatment.  In New Zealand there is no legislation or case law determining if and when minors can obtain contraception advice and treatment without parental consent or knowledge.  This raises concerns for health professionals' practice and minors' status as patients.  This article discusses whether the rulings in Gillick are applicable or even should be applicable to New Zealand with regards to contraception. The article suggests a scheme for giving contraceptive advice and treatment to minors through a modification of Lord Fraser’s guidelines. These modifications have been incorporated into a suggested legislative framework and professional guidelines