The field of medicine is very sensitive and very critical in the lives of people around the world. Medical practitioners are supposed to uphold high standards of ethics in their practice. There are many areas in medicine that have received a lot of views, opinions and criticisms from stakeholders of whether their involvement in them is ethical.
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Furthermore, public debate on the medical issues happening has also intensified with different people airing their view point on the same. One of the critical areas is on the making of decisions pertaining to minors. Medical decision making concerning minors should be left in the hands of specialized practitioners.
There are a number of ethical issues that arise in the medical decisions involving minors. These issues include the scope or the extent to which parents have authority over their children, autonomy for any of children to make their own decisions, and the extent to which state should be allowed to interfere or intervene with the decisions reached by parents (Rosato, 2008, p. 196).
Even though these issues are often debated, there has been no clear consensus reached to revolve them. In general, parents are deemed to poses the right to provide care for their children and therefore, presumed to know what is best for their children.
The society has entrusted the parents of minors with this authority to ensure that they provide care and any other material support for the minors. Therefore, the parents make decisions on the medical situation of their children. The federal and state have limited interference on the parents’ decisions except in circumstances where minors are subjected to harm, abuse or neglect.
There are a number of medical concerns among children which requires making of decision by the parents. For instance, the case of transplant of kidney, separation of conjoined twins, gene therapy and sexual surgery on babies among many others need parent’s decision.
Technological advancement has necessitated these surgeries raising the question on who has the mandate to make the final decisions about such medical complications and how the minors should be treated. For instance, in case parents object to such decisions, is it ethical for the doctors or the government to intervene and make the final decisions?
To solve the stalemate, some federal governments have exemplicitly identified minors as vulnerable and therefore regulate the ways in which children are supposed to access to clinical services and protect them against any harm (Hickey, 2007, p. 100).
In the approval of drugs that minor should use, these states provide incentives and guidelines to the manufacturer to develop specific drugs that are suitable for the minors. Those that do not include children in their drug development are sometime penalized. Therefore, the government can make decisions that it deems right and ethical in protecting the lives of the minor.
In some areas, medical decision making is guided by constitutional law. For instance, reproductive decision making is one of the areas that is constitutionalized at the federal level. This is also one of the areas that minor posses autonomy to make medical decisions (Rosato, 2008, p. 197).
A good example is the case where a minor seek abortion. The minor is not allowed to seek the consent of their parents when the laws provide that the minor girl is mature enough to make decision about abortion and if the decision is in her best interest.
Minor children lack appropriate skills; cognitive ability, experience and judgment to enable them govern themselves. As a precautionary measure, some laws have legislation to exempt children under the age of 12 years from making any medical decisions on their own (Engelmann, Heidi Keller, and Tanja, 2011, p. 242). That responsibility is left to the parents and their caretakers.
Therefore, the right to refuse treatment and informed consent are rights that ate protected by states as they are constitutional rights. Minors who are granted permission to make medical decisions should be well informed before making such decisions (Rosato, 2008, p. 197). They have the right to refuse or accept the treatment since the law permits.
The medical practitioners should provide all the necessary information that will be of helpful to the minors. By complying with the laws, they will be acting ethically and may not be blamed for any consequences that may result afterwards. However, in some occasion, parents acting as surrogates may provide an informed permission for any medical treatment. The child may assent to the decision whenever possible.
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Even though in some occasions minors are required to make medical decisions, the Freidman Ross model (1998) constrained parental autonomy recommends mitigation of parents and guardians in cases where there is disagreement between the decision of the minor concerning medical treatment (Gormley, and Campbell, 2011, p. 22). This is because parents have the legal and moral responsibility to ensure that the health status of their minors is sound.
In case the minor refuses treatment, the model requires permission of long term autonomy instead of the cost of current autonomy. Minor should not look at the current status but consider the future consequences of refusing the treatment under their own conscience (Gormley, and Campbell, 2011, p. 22).
Even though, some minors have the legal right of medical decision making, I tend to disagree with this. Minors lack experience and therefore, require the guidance of the parents in making decision on their medical. Parents have experience and may help in providing better decisions pertaining the medical conditions and even advising on the best medical alternatives. Despite ethics demanding respect of every person rights, minor’s right to medical decision should be limited to foster good medical care.
As minors mature and develop, they become eligible, their mental ability expands and therefore, parents can gradually pass decision making on them (Gormley, and Campbell, 2011, p. 22). It is also the responsibility of the healthcare professional to be ethical in their profession. They should work close with the family members of the minors and provide good advice in order to ensure that minors make right decisions.
The relationship between the doctors and minor also contributes a lot to the decision making of the minors. Therefore, health professionals should endeavor to promote positive relationship between them and the minor to make the minors make informed decision on their treatments. The health professional can also provide information and knowledge that can help in reaching consensus between the minors and their family on medical issues.
Laws that permit minor to make decision pertaining to their health should also be cautious and strict to ensure that they do not make minors to refuse treatment. Minors which should be permitted must be proved to have developed their cognitive ability and able to make decisions that are informed. The fact that many minors at some point are resilience may contribute to making of wrong decisions (Gormley, and Campbell, 2011, p. 22).
This topic is important as it will help parents, healthcare professional and minors to understand the legal requirements and uphold to ethical standards in their medical decision making. Minors, in some states have been permitted to make decision pertaining to medical while others have not. In my opinion, there is more that needs to be done to ensure that minors are allowed to make decisions, and do so in a manner that promotes good health care.
Even if every person has the right to make decisions on whether to seek treatment or not, states should intervene and provide best advice to ensure that ethics are upheld in the practice of medicine and the rights to access medical health are promoted.
Minors lack experience and they should be guided by their parents and guardians and their health professionals. Laws that endeavor to protect minors from mistreat should be enacted to ensure that they are protected and given the desired services/treatment.
Allowing minor to make medical decisions is a way of ensuring that the minor’s right to autonomy is respected. It is a good idea if minors are proved beyond any doubt that they have developed cognitive ability to make decisions on their own.
The minors who demonstrate those experts should be the only ones allowed to make such decisions. The states should therefore come up with laws that helps in determining those minors that can be allowed to make decisions as this will ensure that their rights are adhered to.
The pros of involving the minor in medical decision is that it helps them to gradually understand how decisions are made and therefore helps in developing their mental skills as they grow. Therefore, when they are mature they will have developed their skills in decision making which will help them make appropriate decision in their lives.
On the other hand, the cons of engaging minors in medical decision making process should be also given a lot of consideration. Minors that may be involved in the medical decision making my not be able to make correct judgment due to inadequate experience and information. Therefore, such minors are at a risk of accessing to preferred medical practitioners. Hence, parental guidance should be provided to ensure that such minors make the right judgment.
In making medical decisions, consideration should be given to all the interests parties i.e. the parents, minors and the health professional. Autonomy, respect and privacy should be upheld in the decision making process with the minors autonomy, self determination and best interests always being respected. In the hospital context, health professionals involved in a situation involving an issue with minors over treatment decisions should contact respectively manager in time.
This will help such health providers to avoid any ethical issues or conflicts among them. The minors that meet the threshold of making decisions should be granted this right but, interventions by parents and health care professionals is necessary to ensure that medical ethics are maintained.
Engelmann, M., Heidi Keller, N., and Tanja, K. (2011). Medical decision making: Shared decision making in medicine: The influence of situational treatment factors, In Patient Education and Counseling. 82(2):240-246.
Gormley, F., and Campbell, A. (2011). Factors involved in young people’s decisions about their health care. Nursing Children & Young People, 23 (9):19-22.
Hickey, K. (2007). Minor’s rights in medical decision making, JONA’s healthcare Law, Ethics, and Regulation, 9 (3): 100-104.
Rosato, J. L. (2008). Foreword, Houston Journal of Health Law and Policy, 195-206. Retrieved from http://www.law.uh.edu/