Treatment of Minors
| Author | Jeffrey Wilson |
| Pages | 921-924 |
Page 921
Fifty years ago, the issue of medical treatment of minors—children under the age of 18—would never have been considered controversial. At that time, parental consent was required for almost any type of medical treatment, as it was required for any other situation involving children. Minors were simply not considered competent to make medical decisions.
However, the past 50 years have witnessed a gradual expansion of the rights of minors, and health care has been no exception. Minors who previously had no medical rights now found themselves in the position of making decisions about the most intimate medical procedures.
But the area of medical treatment of minors is still controversial, especially as it relates to certain procedures and conditions such as abortion and sexually transmitted diseases. Many states grant minors broad leeway to determine the course of their medical treatment, and others grant them very few rights. There is little agreement by either medical professionals or state lawmakers as to how far minor rights should go regarding medical treatment.
What is at issue in the debate over minor rights to medical treatment is a tension between the parental responsibilities toward the child, the immaturity and vulnerability of children, and the child's right to be emancipated from the decision of the parent. This tension has produced a patchwork of laws and makes it difficult to make any overriding statements about minor and parental rights in regard to medical treatment.
The crux of the debate over the treatment of minors is the doctrine of informed consent. A person must offer informed consent to any medical treatment given to them, or the physicians involved can risk legal liability. Informed consent has always been a crucial part of the doctor-patient relationship, and has been viewed by courts as a fundamental right.
But in the case of children, the question is, can they offer informed consent, or does that informed consent have to be provided by their parents, who may be seen as more capable of making a knowledgeable decision on a subject as important as medical care. Beyond this simple question are an important set of underlying questions, pertaining for example to the age at which a child may become capable of informed consent, and whether there are
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certain procedures in which informed consent is more important than others.
In general, for most medical procedures, the parent or legal guardian of the minor still has to grant consent in order for the procedure to be performed. While the state can challenge a parent's decision to refuse medically necessary treatment and can in some cases win the authority to make medical decisions on behalf of the child, the minor can not make his or her own medical decisions.
This general rule is virtually always the case regarding any sort of medical treatment before the minor enters their teenage years—no state or court has ever authorized minors younger than 12 to make any sort of medical decision for themselves. But after the minor becomes a teenager, states begin to digress in terms of the responsibility the minor can take for medical decisions. Exceptions have been carved out for various medical procedures that allow teenage minors to have final say in their medical care.
Twenty-five states and the District of Columbia have laws that explicitly give minors the authority to consent to contraceptive services, and...
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