Why Should Minors Be Able To Make Their Own Medical Decisions?

Capacity is defined as the maximum amount that something can contain (Capacity). In the medical field, capacity is the patient’s ability to understand information about an illness and information about the proposed treatment options in order to make an ideal decision that is both compatible with their values and preferences (Karlawish). When it comes to medical decision-making, capacity is a necessity of a patient in order to be able to make their own decisions. In most cases, the question of who gets to make the medical decisions for a patient is resolved as soon as an adult steps into the picture – be it a physician or a relative of the patient. However, when the situation involves a minor – defined as those between the age of 13-17 – the
During adolescence, the brain is still developing. There is an “imbalance” between the mature part of the brain and the immature “cognitive and executive function systems” of the brain, which results in the adolescent’s behavior (Erwin). The cognitive system of the brain develops during the process of “synaptic pruning”. Synaptic pruning is the process of eliminating “unused connections” (Erwin) between neurons – the cells that process and transmits information – and replacing those neuronal structures with more complex and efficient structures (Neurons & Synapses). According to Erwin, by the age of 16 the brain, and the person, is capable of more “abstract, deliberative” thinking. However, when it comes to completing complex tasks, adolescents’ thinking does not reach adult levels until later in their 20s when more parts of their brain correspond to each other. Executive functions – cognitive skills that are required for “goal-directed behavior”, such as planning and attention – allows a patient to access information and execute a planned action. This does not occur until the early 20s or later when myelination (Blum) occurs. Myelination is the process of creating
Like many other cancer patients, the minor was required to receive chemotherapy as a treatment. However, unlike most patients, the boy was to have an “amputation” of one of his legs. Amputation was required to “potentially” save him. The boy refused to receive the treatment in the fear of one of his legs being cut off. Emotional conflict is high during adolescence, and, thus, this causes adolescents to make risky decisions that are not suitable regarding their physical, or mental, health. By choosing not to amputate his legs, the boy was risking his life since the tumor will only grow bigger. According to Kathryn Hickey, under “hot” conditions, adolescents tend to only look at the “short-term consequences” and not at the long-term consequences. Thus, “hot” conditions that include “emotional arousal” and “peer influence” result in poor judgements.
Kathryn Hickey has a bachelor’s degree in Registered Nursing and works at Shriners Hospital for Children in Chicago. She is a credible source as she often deals with children or adolescents and is highly knowledgeable about the topic. Her article, “Minors’ Rights in Medical Decision Making”, was placed in the journal called JONA’s Healthcare Law, Ethics, and Regulation. This journal provides information on the changing regulations of healthcare and is