Patient autonomy – what does it mean for clinical decision-making in children and adolescents?
- Author:
Thor Willy Ruud Hansen
- Publication Type:Review
- Keywords:
Bioethics;
Autonomy;
Children and adolescents;
Decision-making competence;
Best interest;
Parental authority;
Emancipation of children
- MeSH:
Personal Autonomy
- From:International e-Journal of Science, Medicine and Education
2016;10(1):3-9
- CountryMalaysia
- Language:English
-
Abstract:
Autonomy implies the right of a competent
patient to make decisions about their own health
care. To exercise autonomy a patient must receive
an explanation of his/her condition. True autonomy
presumes intellectual understanding, the ability to
translate theoretical ideas into real-life concepts, and
emotional connectedness to the situation.
Children may not be able to understand or process
information about treatment choices. Therefore,
responsibility for decision-making is vested in the
parents. In Norwegian law, this lasts until the child is
12 years old, though the child must be informed and
involved commensurate with intellect and maturity.
From the ages of 12 until 16, the youngster should
increasingly be heard and involved, and from the age
of 16 years a youngster is considered medico-legally
competent.
Parents who face serious illness in a child are in a life
crisis. Yet in spite of this, decision-making competence
is often assumed. Decisions with life-or-death or lifetime
implications will profoundly influence the life of the
family. The best interest of the sick child may not
necessarily be compatible with the needs of the family
as a unit. As medical caregivers we should be cautious
about assuming that our insight into such family realities
is adequate. We must sensitively, yet critically, consider
decision-making competence, while at the same time
supporting the parents’ efforts to cope and make the best
decisions possible. However, we must never lose sight
of the fact that our primary responsibility is towards the
sick child.
- Full text:P020160408590162772286.pdf
