Self-determination, healthcare treatment and minors in Italian clinical practice: ethical, psychological, juridical and medical-legal profiles (original) (raw)
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Bioethical Aspects in the Approach of the Minor Patient – General Review
2021
Corresponding author: Cristina Raluca Bodo E-mail: cristina.bodo@gmail.com ABSTRACT The objective of this review was to present the main ethical issues in minor patient healthcare activity including: minor patient consent, parental consent, confidentiality and medical examination. The particular ethical issues that arise in the medical care of children and adolescents overlap with those of other patients, who lack decision-making capacity or have diminished decision-making capacity. Children should always be respected as persons. A consent from the child and parental permission be sought whenever possible, by using appropriate tools. Even minor patient demonstrated the ability to understand essential elements of healthcare activity and the details of the medical examination, there is variability in children’s level of understanding, mainly due to their age and maturity. The legal framework in every country represents a guide for the medical doctors and a reference for their patients.
Minors and Informed Consent: A Comparative Approach
European Journal of Health Law, 2007
Th e European Convention on Human Rights and Biomedicine of the Council of Europe provides in article 6 for special protection of persons who are not able to give free and informed consent to an intervention in the health fi eld, e.g. minors. According to the second paragraph of this article it is up to domestic law to decide whether and under which conditions a minor is capable of taking autonomous decisions in the health fi eld.
Anales De Pediatría (english Edition), 2017
The conflicts that arise when minors or their legal representatives refuse to receive medical treatment considered necessary by the paediatrician pose a serious ethical dilemma and also have a considerable emotional impact. In order to adequately tackle this rejection of medical treatment, there is to identify and attempt to understand the arguments of the people involved, to consider the context in each individual case and be conversant with the procedure to follow in life-threatening scenarios, taking into account bioethical considerations and the legal framework.
Autonomy of Children in Medical Decision-Making and the Extent of Parental Authority
2018
The protection of the rights of all patients and ensuring that autonomy is exercised within each individual's intellectual ability is one of the most important goals of law and ethics in medical practice. The present paper joins a vibrant conversation in medical law about the increased focus on the decision-making capacity of children and young persons. It considers the refusal of the law to outrightly deny children the right to make decisions regarding their medical treatment, the extent of their parents' authority and the role of courts, based on the best interests principle. This new lens represents a recognition of the possible variations in cognitive strength of the same age group, and the pragmatic consideration that certain circumstances and specific context in the decision-making process could enhance capacity irrespective of a child's age. When a child is found to possess the capacity and maturity to understand the various implications of a medical treatment, including the risks and benefits, such a child, just like an adult, can give an effective consent on his or her own behalf.
European Journal of Formal Sciences and Engineering, 2023
Lately lawyers and medical professionals pay more attention too the process of minor patient healthcare. The research shall address the issues of legal relationship between minor patients and medical professionals, consent to treatment of minor patients and communication problems including the scope of information which the doctor can provide to the minor patient's relatives to protect themselves and patients. Legislation prescribes that the information provided by the medical professional to the minor patient must be not only easy-to-understand, but also be consistent with the patient's age maturity. However, in Latvia, for example, there are no guidelines that specify how medical professionals can determine the patient's maturity. In the course of provision of medical services to the minor persons legal disputes involving communiucation failures between the minor patients, their relatives, legal representatives and the doctors arise increasingly frequently. The research will look into issue of communication problems in healthcare. The aim of the research is to provide insight into challenges of legal relations betweem minor patients and medical professionals and communication problems in healthcare.
The Legal Authority of Mature Minors to Consent to General Medical Treatment
PEDIATRICS, 2013
The nature and scope of mature adolescents’ legal authority to consent to general medical treatment without parental involvement is often misrepresented by commentators. This state of affairs is further complicated by the law itself, which has developed a broad “mature minor exception” to the general requirement of parental consent in abortion cases and which has additionally carved out numerous specific status-based and condition-based exceptions to that requirement. In these circumstances, it is not always a simple matter for physicians and other medical professionals who treat adolescents to ascertain the applicable law. In this article, we discuss the underlying differences between medical ethics and law, which have caused some of the confusion in this area, and we set out the most current legal rules governing adolescent decision-making authority in general medical settings. A comprehensive analysis of both statutory and common law demonstrates that in such settings, parental c...
In bioethical issues, the major role played by the self-determination principle in the decision-making process has completely redefined the hierarchy of principles inspiring medical profession. Concretely, this means that in principle the deci-sional power is no longer exclusively exercised by doctors according to the well-known paternalistic model. In the new scenario, where self-determination plays a key role in health care relationships, the patient has the definitive say on acceptance or refusal of medical treatments. In fact, not only has the self-determination principle gained widespread acceptance and plays a leading role in ethical theories and medical ethics, but it has been legally ruled. The self-determination principle has undergone a paradigmatic process of extension and specification also with regard to mi-nors' participation in the decision-making process at the end-of life. The aim of the paper is to restate the ethical and legal status of minors as regards decisions at the end of life. The first step will be contextualization of this extension with regard to decisions concerning minors' health within the framework of the European continental legal tradition. Second, the analysis will focus on the main legally binding and non-binding documents that contribute to outlining minors' rights at the end of life. Finally , it will argue that whenever minors are involved in sad and painful decisions like the ones at the end of life, parents or the legal representative and physicians should always try to include them in the decision-making process, that is, to decide 'with' and not 'for' the minor.
A comparative assessment of minors’ competence to consent to treatment in Polish and English law
Progress in Health Sciences, 2015
The publication concerns the problem of minors' consent in regard to health services. The authors have provided legal solutions adopted in the UK and Poland. The British case law presented in the first part of the article provides that minors have the opportunity to decide on issues relevant to their own health. The ruling which made a breakthrough in automatic treatment of all children (0-16) in the same way was the Gillick case. Since then the test of actual competence has depended on whether the child is able to make a reasonable assessment of the advantages and disadvantages of the proposed treatment and the type of medical intervention, not on age. The British Medical Association has developed manuals to facilitate proceedings of assessing the ability by the physicians. In turn, the Polish legislator in relation to the consent of minors under 16 to treatment introduces only one criterion: the age. Children under 16 years of age, even if they are competent, are not asked for permission to violate their physical integrity. Legal representatives (in the case of medical examination-actual custodians) are solely entitled to express the consent. In turn, minors above the age of 16 are entitled to consent together with their legal representatives (the actual custodians). In the case of dual consent, in principle, both entities should actually be capable of expressing it. Reading of the provisions of Polish medical law, however, leads to the conclusion that, in fact, the competence of parents is the most important. In the case of a minor patient's (over 16 years of age) incompetence, consent is made only by his legal representative. In contrast, in the case of a minor's opposition, the doctor does not examine his actual competence, only whether the patient is acting with sufficient discernment and refers the matter to the guardianship court.