Minors+&+Medicine+(Pd+6)

=Bioethics involved in //**Minors and Medicine**//= **__The issue:__**
 * Consent (or lack of)- The rights of minors to make medical decisions on their own
 * Confidentiality- Parental rights to information about their children

**__Sociologist's Perspective__**
** AGAINST ** CONFIDENTIAL HEALTH CAR E     -    Confidential care for minors authorizes the adolescent to make his/her own decisions when they may not be prepared to. -  Promotes dishonesty between youth and parents. -  Interferes with the parental decision-making authority that is a parent’s right and responsibility. -  Parents have a right to know and take part in decisions influencing their child's health and well-being. ** FOR ** CONFIDENTIAL HEALTH CARE -   fear of embarrassment, disapproval, and/or violence -   parent may be cause or focus for adolescent’s situation -   adolescent values privacy and independence -   more teens will seek help when they know that confidentiality is assured. o  Only 45% of adolescents surveyed would seek care for depression if parental notification was required.  à  teens honest with doctors  à  more effective/accurate treatment   o   physicians strongly support confidentiality and minors’ rights.  §   Of the physicians surveyed, 75 percent supported confidential treatment for adolescents. -   adolescents must learn to assume greater responsibility for their own health care. -   As the child matures, the level of confidentiality should also increase. -   With confidentiality, incidence of STDs will decrease with treatment. -   Problem needing treatment is against family values/religion. - Mandatory parental consent can delay adolescents from getting timely medical care and intensify the risks related with an existing health problem.

__Lawyer's Perspective__
-Minor: any person under 18. -Emancipation Statute: attain adulthood before legal age. -Financially independent. -Free of care and control. -Living independently. -Varies down to county level. -Informed Consent: treatment authorization given by the patient to the physician. -Parental Consent: parent’s choice. -Parental Notification: parent must be told, but do not have choice. -Minors must have parental consent before receiving medical treatment, except if: -Emancipated. -High school graduate. -Married or has been pregnant. -Emergency—no consent needed. -Abortion always requires parental consent. -Test/treat STDs—age 12. -Drug/Alcohol—minor consent, no notification. -Inpatient care—over 14, minor’s consent. -Parental notification. -Outpatient—over 14, minor’s consent. -No parental notification. -Confidentiality: when minor has consent. -Patient must give written permission for to let information be passed to parents. -This law is very controversial and often ignored.

__Scientist's Perspective__

 * First DO NO HARM!**
 * Laws state that doctors are allowed to treat minors (defined by the state) for sexually transmitted diseases, alcohol and substance abuse, or contraception and pregnancy care.
 * If an adolescent seems suicidal or is having mental issues that can cause harm to the adolescent or others the parents must be informed.
 * If sexual or physical abuse is suspected doctors should take the appropriate steps with the proper agencies. They also then have a right not obtain parental consent
 * Doctor-Patient relationships are extremely important and crucial ... means for keeping things confidential and not informing parents
 * book __Legal Issues in Pediatrics and Adolescent Medicine__ by Angella Roddey Holder

Educator's Perspective

 * Should minors be allowed to make medical decisions such as surgery and abortion on their own?
 * In what ways could needing parental permission be damaging to the child and its health?
 * Should doctors be required to inform parents about their children's medical conditions/activities (pregnancy, STD's, illness, birth control)?
 * What are some reasons why telling the parent could be detrimental to the child's physical and mental health?
 * What are some benefits of telling the parents?
 * Why is confidentiality beneficial in healthcare of children?
 * How would your honesty with a doctor about an STD change given the presence of a parent or the knowledge that a parent would be told?
 * If a child suffers an injury but no parent is reachable to give consent for medical care:
 * Should a doctor evaluate him in the waiting room?
 * Should a nurse be able to take his vital signs?
 * If the injury is not deemed a true emergency, should they send the child home to return with parents?
 * Should he instead be x-rayed and treated even without consent?
 * What complications could treating the patient bring about? Do these complications outweigh the benefits of treating the patient?
 * If a teen seeks treatment for a venereal disease, but does not want his parents notified:
 * Should he be treated anyway?
 * Should he be refused treatment until parental consent is gained?

Works Cited Loxterman, John. "Adolescent Access to Confidential Health Services." Advocates for Youth. July 1997. 20 May 2008 <[|http://www.advocatesforyouth.org/PUBLICATIONS/iag/confhlth.htm>.]

Meisel, Alan, J.D. "Case: Rights of Minors." __Ethics in Emergency Medicine, Second Edition__. Ed. Iserson KV, Mathieu D, and Sanders AB. 28 May 2008 [|http://www.galenpress.com/extras/extra21.htm>.]

Plaza, Joyce. "Treatment of Minors for STDs." The American Journal of Bioethics. 26 Oct. 2006. 20 May 2008 . Web Evaluations  http://www.galenpress.com/extras/extra21.htm appears to be a reliable source because it is a published essay in an anthology of works on the rights of minors in medicine. It is not biased because it is compiled by a group of people attempting to create an educational piece on the laws and ethics involved in medical issues with minors from a purely factual and informative perspective. Also, the author of the used section of text, Alan Meisel, J.D., is a juris doctor, and therefore is a lawyer in the medical field, making him a very reliable source of information.http://www.advocatesforyouth.org/PUBLICATIONS/iag/confhlth.htmJohn Loxterman wrote the article “Adolescent Access to Confidential Health Services” that I used for my research. He has a professional doctorate in law. His article is featured on the website www.advocatesforyouth.org which is an organization that helps young people make responsible decisions about their sexual health. Advocates for Youth views sexuality as normal and healthy and believes that young adults deserve rights, respect, and responsibility. The article was written in July 1997 and the website is regularly updated with important discussions of certain topics and issues. Their information is from several medical associations and also from other organizations similar to Advocates for Youth. This information is useful for my purpose because it shows 2 different views of the issue at hand and supporting statistics for both perspectives. As socialist, I got most of my information from this organization’s website because it was not very biased. It seemed to lean towards supporting confidentiality for teens because this is beneficial to childrens’ health, but it did provide the cons to hiding health affairs from parents as well.

Bibliography Plaza, Joyce. "Bioethnics on NBC's ER" The American Journal of Bioethics. Oct. 26 2000. http://www.bioethics.net/articles.php?viewCat=7&articleId=140.

Web Evaluations This website http://www.bioethics.net/articles.php?viewCat=7&articleId=140 was a good source because it came from a reliable source with many refrences. It is not biased because it is going off of the law and is more of a way to explore how people think. As the scientist it is my job to learn what doctors have done that involve the subject and this webstie has helped a lot. It is a good rescource because it lists all of it's rescources underneathe it. Web Evaluation Duvall, Clara. “Minor’s Access To Confidential Health Care in Pennsylvania”. July 2005 __[|http://www.aclupa.org/.__ 26 May 2008. [|http://www.aclupa.org/education/clarabellduvallreproductiv/minorsaccesstoconfidential/referencecardminorsaccesst.htm This source seems to be reliable because it was written and developed by many well known organizations and hospitals, such as The Children’s hospital of Philadelphia. The article was written in July 2005. It is a (.org) site, which means it is a nonprofit organization. The website of the article is the site of the American Civil Liberties Union of Pennsylvania. It presents factual information with no attempted persuasion or bias. The website was very effective for my use, and I would recommend it to another student because it clearly states the law and provides a clear interpretation.