When I was researching a topic for the third essay, I came across the ethical dilemma of whether teenagers should be able to make decisions in the context of life-altering situations such as surgery or the refusal of certain medical treatments. A teenager under 18 is not legally in charge of his or her own medical care, but the question is should they be able to make their own decisions? There is a very arbitrary line drawn at the age of 18 when an individual is suddenly capable of legally making all the decisions in his or her life. Ironically, the day before your 18th birthday you need parental consent and are considered incapable of these same decision making processes? A better judge of capability is the level of maturity of such an individual, because it is quite clear from everyday experience that some individuals are mature beyond their years, and just as many are the opposite; they are extremely immature.
One example comes to us from Britain, where a 13-year-old girl decided to refuse a life saving heart transplant. Understandably, this worried a few of her doctors and outside observers. They said she was making a rash decision and that she did not have enough life experience to know what was truly good for her. However, she had thoroughly thought about the surgery and decided that one more surgery would only prolong her life a little longer before she needed another one too. Also, she wanted to spend time with her family instead of in a hospital and believed she would be saving the life of another patient who needed a heart transplant. Her rational, logical argument and contemplation convinced the lawyers and the local child service agent as well as a good number of those who learned of her story. This rational and convincing logic is a sign of maturity, and teenagers who can make decisions in this fashion seem to be capable of choosing what is best for them. However, these teenagers still lack the degree of knowledge their parents and doctors have, so the question remains, who makes the decision in these cases?
Souces Relevant to my post:
“Teenagers and the right to be wrong” by Dominic Wilkinson
November 14, 2008 on the website Practical Ethics: Ethical Perspectives in the News
“Hannah's Choice: Saying No to a New Heart” by Nancy Gibbs.
Thursday, Nov. 13, 2008 in Time.com
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3 comments:
I agree that informed medical consent is an area that is often difficult to determine. Although now it is universal that someone is an adult once they turn eighteen years old, it would make more sense for the mental capacity or the maturity of the patient to be evaluated in order to decide whether or not a patient can give his or her own consent. For example, does it make sense for an eighteen year old with a mental disorder that is not severe enough to require the intervention of a third party to be able to make his or her own decisions, while a mature thirteen year old girl with logical reasoning may not be able to do the same? Many children do need their parents to make decisions until they are eighteen, but some patients do possess the maturity and logic of an adult that should be honored.
Although many doctors and ethicists argue that children do not know or have not experienced enough to make informed decisions, children with life threatening diseases often become much more mature than other children their age. Having been faced with medical decisions for most of their lives, they can understand much more about life and death. When considering the fact that her life was in danger, the thirteen year old girl could see beyond the present surgery and into the future when she would probably need another one. By refusing the surgery, she made a selfless decision that reflected her maturity. Although children should still try to make these decisions with their parents, the child’s decision eventually should be honored if it is logical enough. We should still use eighteen as the point at which most people should be able to make informed decisions, but cases in which the patient shows maturity and strong reasoning should be tried on a case by case basis, regardless of his or her age.
A Minor's Right to Have an Abortion
The issue of minors making their own medical choices is an important one that is especially interesting in the case of abortions. Generally, one of the main arguments used to support a woman’s right to abortion is that all women should have the right to have control over their own bodies. Does this assertion not apply to 17 year old young women as well? As of 2009, while abortions are legal in all fifty US states, in only 15 states are minors able to get an abortion without parental involvement (Guttmacher Institute). This suggests that our society as a whole is more willing to protect an “adult” woman’s right to control over her own body than a minor’s right to control over her body.
I would argue that if a young woman makes the decision to have sex without the need to consult with her parents then she should also have the right to choose to have an abortion if she so decides without parental involvement. While I would not necessarily argue for minors to be able to consent to all types of medical treatments without their parents’ knowledge, I believe that abortion is a different case. Having a child is a major life changing event and requires a certain degree of preparation as well as willingness to have a child. I believe that it would be disadvantageous both for the new mother and for the newborn child for a pregnancy to be sustained against the mother’s will.
One argument for parental involvement in teenage abortions is that laws of this sort will decrease teenage pregnancies, acting as an extra deterrent to minors having unprotected sex. However, a recent study found this not to be the case: parental involvement laws decreased abortion rates among minors but did not change pregnancy rates. This would indicate that there were more unwanted births than in the case of no parental involvement (Colman et al.)
In summary, I believe that young woman under the age of 18 who become pregnant by mistake should not have to face additional obstacles in getting an abortion aside from those that many women already face: the social stigma, feelings of guilt or sadness, and other emotional burdens. A sixteen or seventeen year old should be allowed the same rights to her body as a woman in her twenties.
Related Links:
“State Policies in Brief.” Guttmacher Institute. 1 Dec. 2009. 1 Dec. 2009.
Colman et al. “Misclassification Bias and the Estimated Effect of Parental Involvement Laws on Adolescents’ Reproductive Outcomes.” American Public Health Association. 98, no. 10 (2008). 1 Dec. 2009.
18 is the age that the government and society have deemed to be the age of adulthood. The government could have just as easily chosen 17, 22, or 5. However, around the age of 18, people are generally expected to be more experienced, level-headed, and competent of weighing the consequences of their decisions. Whether people are actually this mature at this age is often questionable. Conversely, some people are evidently capable of reasoning, making mature decisions, etc. before they turn 18. For the sake of keeping a standard across the nation, people are legally declared adults at one specific age. However, in cases where a minor wishes to decline life-altering medical procedures, I think doctors and other adults, who do have more life experience, should assess the maturity of the minor and see if they are mature and level-headed enough to make such a solemn decision.
In the case of the British girl that Melissa discussed, she appeared to have lived with a painful, life changing medical complication, perhaps something that other adults have not even experienced. Certainly, the doctors and adult family members did not just agree to decline the heart transplant once the girl mentioned her wish to decline such a procedure. On the contrary, doctors and family members informed her of the consequences of such a choice and probably actively tried to dissuade her. However, as Melissa describes the girl, she seems to have put very much thought into her decision and weighed the consequences of the options. At this point, the girl seems to have been more than capable of making such a decision.
In general, minors are too young to make decisions like this, but when minors display well thought out reasoning, comparison and realistic understanding of the implications of their decisions, and satisfaction with their decision, they should be allowed to choose whether to accept a life-changing procedure or not. Of course, such decisions are very solemn, and must not be taken lightly, and the minor should be informed of everything possible, but if the minor knows the information, and has thought deeply, he should make the decision. Of course, situations like the 13 year old British girl’s should be assessed on a case by case basis, because some minors are not mature enough to make such decisions.
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