The Legal Process of Medical Consent for Adolescents

As Albert Einstein once said, “The only source of knowledge is experience.” Seeing that I agree with Einstein, I stand in firm negation of today's resolution which states Resolved: Adolescents ought to have the right to make autonomous medical choices. For simplicity in the debate today, I would like to give the following definition from the Black’s Law Dictionary: Adolescence is the age which follows puberty and precedes the age of majority. It commences for males at 14, and for females at 12 year completed. The Oxford Advanced Learner’s dictionary says that the word ought is used to indicate a desirable or expected state. Autonomous, as defined by the Oxford Dictionary of Philosophy, is having the freedom to act independently. The negative will support the value of paternalism, which as defined by the Stanford Encyclopedia of Philosophy, is the interference of a state or an individual with another person, against their will, and defended or motivated by a claim that the person interfered with will be better off or protected from harm. The value of paternalism will be defended with the criterion of knowledge and experience.

Treatment without consent - Charlotte, the nurse on duty, had forced James into getting the injections therefore causing him emotional distress. Treating a competent patient who has validly refused treatment could constitute an assault or battery. The legal provisions supporting a competent patients’ right to refuse treatment in Australia can be found in both legislation throughout all the States and common law. The Australian Charter of Healthcare Rights is also a helpful source of guidance as it reinforces the common law position that is based upon the principle of patient autonomy. The High Court of Australia first articulated the principle or refusal of treatment in Marion’s case, stating that a legally competent person has a right “to choose what occurs with respect to his or her own person.” Under the NSW Health Patient Charter, consent in regard to an operation, procedure or treatment is both a specific legal requirement and an accepted part of good medical practice. Medical practitioners are also expected to clearly explain proposed treatment, and adequately inform their patients on significant risks and alternatives associated with the treatment.Failure to do this could result in legal action for assault and battery against a practitioner who performs the procedure. Charlotte made no effort to explain or gain a consent from James.

Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment

According to Beauchamp and Childress, the principle of autonomy asserts that a capable and competent individual is free to determine, and to act in accordance with, a self-chosen plan (Beauchamp and Childress as cited in Keating and Smith, 2010). Determining a patient's competence is critical in striking a proper balance between respecting the autonomy of patients who are capable of making informed decisions and protecting those who are not fully capable (Appelbaum, 2007). Tagging children incompetent solely on the basis of their age and not involving them in decision making regarding their health is violation of children's human right. Obtaining consent from parents, rather than children, negates one of the most important principles of medical ethics, which is patient autonomy. Nurses are obligated to promote the health of children by embracing children's right. Nurses' duties which stem out of respect for autonomy include both duties to ensure children's self determination is respected and to refrain from practices that interfere with the children's right of decision making (CARNA,

There are a number of legal and ethical duties expected of nurses. Most of these involve care for patient’s autonomy and confidentiality despite the medical care. Failure to act regarding these can give rise to liability. One aspect of Patient’s autonomy involves giving or withholding his consent about treatment. This paper takes into account ‘consent’ as the aspect of law regarding nursing.

The aim of this essay is to presents a critical analysis over the nursing dilemmas around capacity and her limitation by presenting example from the author’s practical experience. The names of the patients will be replaced with pseudonyms for confidentiality purposes according to the Nursing and Midwifery Council NMC(2015) Code of Conduct. Consent is often misunderstood. Mental Capacity is a complex topic and often health professionals tend to provide treatment which may be in the patient 's best interests but not always in accordance with his will and preferences thus adhering to Personal-Centred Approach. Further will be discussed Assessment of capacity and risk assessment, The Principle of Best Interests, Deprivation of Liberty Safeguards(DOLS), accepting Advanced decisions if they are in place. Moral and ethical considerations asociated with mental capacity will be presented throughout the essay.

In this assignment I will be discussing Adult Nursing and Mental Health Nursing and issues regarding consent. Consent is important within all fields of nursing as it is essential to conduct any medical procedures. The Nursing and Midwifery Council Code of Conduct (NMC,2008) states that all healthcare professionals must presume that all patients have the mental capacity to accept or deny medical treatments after being given all information which may be needed. However there may be some instances where consent cannot be obtained. An example of this is if the patient is in a medical emergency and may be unconscious or if the patient lacks the mental capacity to make a knowledgeable choice. In this situation treatment would be

Many define adolescence as the transition period from puberty to legal adulthood where one is in the process of maturing. “This transitional period can bring up issues of independence and self-identity,” according to Psychology Today (“Adolescence”). Adolescents are usually classified to be between the ages of 14 and 18 and traditionally regarded as “minors” by law. “Minors, as a group, are legally disabled, meaning they are presumed to lack the skills necessary for capable decision-making” (Rhonda). Adolescents are unable to make rational decisions due to the Prefrontal Cortex not fully being developed, emotional responses and other factors which may cause potential societal harms as well as risks to the minors. Adolescents should not have the right to make autonomous medical choices.

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

Consent for medical treatment is based on three legal ideals: the patient must be informed to make a decision, the patient cannot be intimidated into making a decision, and the patient must be competent (McCabe). In 1982, a study was held by Weithorn and Campbell showing the competency of four age groups (9,14,18, and 21 years-old) based on questions from the ideals aforementioned. The study concluded that fourteen year-olds’ competence and adult are analogous, while nine year-olds could partake in discussions based off of their treatment (Weithorn). The study conducted by Weithorn and Campbell, not only displays competence, but also the ability to comprehend the possible outcomes, and determine the importance of these possible outcomes relative to their own lives. With studies showing that at the age of fourteen the decisional capacity (prefrontal cortex) of the human brain is equal to that of an eighteen year-old, the legal age of consent must be lowered to fourteen years of age.

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

There are many legal and ethical situations that healthcare providers will be faced with when providing medical treatment to either a child or an elderly adult. While there is often much discussion regarding the elderly and do not resuscitate orders, there are often times when the decisions for health care of a child may be overlooked. Some of the legal issues that may be faced by healthcare professionals are informed consent, confidentiality, reproductive services and child abuse. Patients have the right to decide what is done to their own bodies, but for children under eighteen, their parents decide for them. A major issue faced by healthcare professionals is parental refusal for treatment. Healthcare providers will be faced with many conflicting ethical and legal situations regarding refusal of a minor’s healthcare and treatment. These issues

Within healthcare, practitioners often have to make difficult decisions regarding the care of their patients. This could be to do with giving or withdrawing treatment, or as simple as sharing risk information (Glover, 1997). Ultimately, the practitioner must be able to rationalise any decision they have made (Morrison, 2009). With this in mind, the following assignment will draw upon an ethical dilemma and explore how theoretical perspectives can be utilised within the decision making process. Therefore it will also be pertinent to draw upon the law, and how this influences actions within health care. To facilitate this discussion, I will identify a scenario from practice that

Blackwell, w. (2014) states that we live in a society governed by an excessive extent of rules and regulations. Many of these rules apply to every individual within society for example rules relating to the use of public services; while other rules will focus and apply only to specific groups of individuals such as healthcare professionals. The aim of this assignment is to discuss the concept of consent in relation to the role of the nurse, with the purpose to demonstrate the ethical and legal implication of consent on nursing and professional practice.

The health care industry continually deals with the lives of individuals and is bound by the ethical and legal aspects that influence decisions of health care professionals in their clinical practice. This essay aims to discuss the various issues and ethical dilemmas that arise with regards to the consent of consumers. In the attempt to explore these points, different literatures are used to shed light on this topic. This paper begins by defining what consent is and the role of nurses or the health care team in being an advocate of the patient when requiring consent. It moves on with the discussion of ethical frameworks, which are recognized nationally and internationally, as these carry significant influences in health care decision-making. The essay also brings out the essence of ethical theories and its relevance to consent giving. It then tackles the similarities and differences of the Code of Ethics and ethical guidelines relevant to both nursing and midwives as both professions work closely in the care of mothers, children and families. Issues and views from experienced professionals in these fields are presented and critically compared. It then considers both ethical and legal aspects, which seeks arguments and rational implications. The last topic points to the social and spiritual factors pertinent to consent that impact the society particularly on the care of patients and concludes by summarising discussed points and arguments about consent.