Medical Decision Making for Minors

Unless the minors have fulfilled these conditions, they are automatically considered incapable of making decisions regarding their medication since they cannot understand the complexities of their medical situations. Thus, the minors are deemed to lack the components of competency required to make informed consent. Generally, parents are presumed to act in the best interest of their children. In making medical decisions for their sick children, parents are considered to know the best because of their emotional connection with their children. However, over the years, decision-making by parents with regard to their sick children has declined and therefore the medical interest of the child might shift to the pediatrics. There has been no reconciliation between the legal viewpoints and the ethical perspectives of the medical field with regard to the autonomy and the consent of the minors.

While the legal consent calls for the individual's competency, the ethical aspect of the consent rests entirely on the individual's respect and autonomy. The concept of consent requires that an individual has the legal right to determine what will be done on his or her body. If a consent has to be legally valid, then the patient must understand and retain the relevant information, must believe in that information and be able to weigh the information to understand the outcomes before making the final decision. However, during childhood and adolescence, the components of skills that enhance the competent autonomy as described above are still developing. This paradox is caused partly by the legal system which accepts and differentiates the right of the adolescents to consent to treatment but not their right to refuse to be treated.

Coleman & Rosoff (2013) highlight that a minor who is labeled as mature technically has the same right as a competent adult. This means that the minor has the right to consent to treatment as well as the right to refuse treatment. Generally, the lack of concrete answer with regard to the degree of capacity because of the fluctuating capacity of the minors and difficulties in measuring the capacity leads to physicians or judges using their professional subjective judgment to make mistakes on the grounds of protecting the minors. Rather than acknowledging any capacity in minors, doctors and judges give the power of decision-making to the guardians or parents as the natural decision makers of their children. In reality, there are many instances where the parents fail to act in the interest of their child although the parents' intention was to do so.

A majority of the parents tend to give false information by omission or white-wash the truth in the name of protecting their child. Unlucky to them, minor children have portrayed an intuition in such cases and often realize that all is not well. This places emotional turmoil, confusion, and burden on the child to not talk about the illness openly as per their wishes for the sake of the parents (Hill, 2012). The failure to meet the child's best interest can be determined in cases where a parent refuses treatment, for instance refusing blood transfusion as noted in those who subscribe to the faith of Jehovah Witness on the grounds of the best interest of the child. One major problem is that whenever there is a disagreement between a minor and the guardian, the judicial system does not offer legal criteria to guide the conflicting parties on how to handle that matter.

In accordance with Partridge (2010), the principle of beneficence, physicians should strive to promote the interests of their clients through conferment of benefits upon them. In this regard, parents are not wholly superior to children in making medical decisions. In conclusion, there is a need for balance because there are logical, ethical as well as practical issues in allowing either the minor or the parent to be the only decision-makers in matters of treatment. There is a need for the integration of all the systems so that the voices of all the parties can be respected. Hill, B. J. Medical decision making by and on behalf of adolescents: Reconsidering first principles. J. Health Care L.