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Overriding an adolescent’s refusal of life saving treatment: A US case reminds us of the ethical issues at stake.

As we have previously covered, in the UK the ability of teenagers to refuse treatment before the age of 18 when it is held to be in their best interests is limited – the Courts deciding forced treatment would be lawful whether with Jehovah’s witness cases, or the paracetamol overdose case covered in the media last year. However, in the USA the mature minor doctrine has permitted teenagers to refuse treatment and die, (1) even when they are as young as 14 years. (2)

The Connecticut Supreme Court ruled that a teenager of 17 years who refused chemotherapy with an 80% chance of cure for Non-Hodgkins lymphoma, without which all agreed that she would die within a couple of years, should  be confined to hospital and treated against her wishes . The girl, whose mother supported her decision to refuse treatment, is appealing the decision.

http://www.theguardian.com/society/2015/mar/09/teen-battled-cancer-chemo-treament-remission

In the UK the ability of teenagers to refuse treatment before the age of 18 when it is held to be in their best interests is limited –In several cases the Courts have overridden an adolescents refusal of life saving treatment. While a person aged 16 years an dover is presumed to have capacity and their consent must be respected, the law regarding refusal of treatment between the age of 16 and 18 years is ambiguous. In some US States the mature minor doctrine has permitted teenagers to refuse treatment and die, (1) even when they are as young as 14 years. (2) Connecticut does not have a mature in or doctrine in its legislative framework. The ethical and emotional difficulties of responding to an adolescent who  is competent but refusing life sustaining treatment is the subject of Ian McEwan’s recent novel, The Children Act.

Nancy San Martin, Defiant Transplant Patient Dies at Home, SUN-SENTINEL (Ft. Lauderdale, Fla.), Aug. 21, 1994, at 1A.
http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=692