Arch Dis Child. Published Online First: 1 March 2009. doi:10.1136/adc.2008.149781
Leading articles |
Overriding competent medical treatment refusal by adolescents – when ‘no’ means ‘no’
1 King's College London, United Kingdom
* To whom correspondence should be addressed. E-mail: carolyn.johnston{at}kcl.ac.uk.
Accepted 17 February 2009
Abstract
In an era of patient centred care, competent and informed health choices are accorded respect. But should this also be true for healthcare decisions of young people, even where they conflict with the clinical view of the young person’s best interests? The period of adolescence (from the Latin, ‘adolescere’, to grow into maturity and which could be said to encompass 12 – 17 year olds) signifies a shift biologically, socially, emotionally and psychologically. It is a period when young people start to develop a sense of identity and independence. Over recent years there has been increasing recognition of the importance of respecting the autonomy of adolescents as patients and this has brought into focus the issue of whether they should be allowed to put themselves at significant risk of harm as a result of refusing beneficial healthcare. Interviews conducted with a range of professionals involved with young people in a variety of professional capacities, explored the extent to which they considered that the protection of a young person’s best interests justifies curtailing his/her autonomy.
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