Children's Rights in Refusing Life Saving Treatment (Essay Sample)

Morgan Odhiambo Professor Magak Principles of Ethics, PMC 301 27 October 2023 Children's Right in Refusing Life-Saving Medical Introduction The discourse surrounding children's autonomy in life-saving medical decisions is intricate and evolving. Traditionally, parental authority has been the bedrock of such determinations. However, an emerging perspective argues that adolescents, around the age of 11, possess the cognitive capacity for informed choices, albeit with certain limitations. Drawing from Piaget's cognitive development theory, this paper delves into the cognitive aspect, emphasizing that a child's consent should be contingent upon their understanding of therapy purposes, consequences, benefits, and alternatives. Developmental considerations The debate over children's medical decision-making is complex. The law's concept of the family rests on a presumption that parents possess what a child lacks in maturity, experience, and capacity for judgement required for making life's difficult decision (“Parham V. J.R., 442 U.S. 584 (1979)”). Proponents suppose that adolescents have the cognitive capacity to make decisions about their health and exercise self-determination, although they may lack the experience and right judgement to be self-governing in all aspects. According to Jean Piaget, children start to demonstrate intellectual and abstract reasoning at age 11. Establishing a minor's ability to make a medical decision should involve demonstrating their understanding of the goals of therapies, the potential outcomes, the advantages, and the available alternatives to treatments (Lantos and Miles, “Autonomy in Adolescent Medicine”). Autonomy Respecting a child’s autonomy in making medical decisions is critical, especially in high-risk medical procedures such as sterilization or surgeries. Whether a child can give consent depends on their mental ability or the treatment procedure thereto, wherefore the parents should not have unfettered control over the emancipated minors. However, limitations apply to scenarios where refusal would result in death or harm to the minors. The medical professionals can assess the extent imposing or refusal of medical treatments for a condition (Diekema, “Parental Refusals of Medical Treatment: The Harm Principle as Threshold for State Intervention”). Parental Consent. Parental consent, rooted in the best interests of the child, is based on the belief that parents are uniquely positioned to make decisions that protect their children's immediate well-being and future. The societal ideal of parenthood emphasizes parents' responsibility to nurture and safeguard their children, instilling trust and security. While society trusts parental authority in most cases, it acknowledges that this trust is not absolute. When there is compelling evidence that parental decisions may endanger a child's well-being, society is justified in intervening in matters of parenthood. Such intervention becomes necessary when there are substantial concerns that parental choices could lead to severe harm to the child. However, in circumstances where a medical procedure becomes an urgent necessity and may be the difference between life and death, it is reasonable to entrust parents with the prerogative to consent to these interventions independently of the child's will. This becomes especially pertinent when there are no feasible alternatives and time is of the essence. It is crucial to ensure that decisions regarding a child's health are based on the best available evidence and medical consultation, harmonizing the delicate balance between parental authority and the child's well-being, as outlined by Turnham et al. ("Minority Report: Can Minor Parents Refuse Treatment for Their Child?"). Balancing Children’s Autonomy with Informed Consent Regardless of the extent to which children are granted authority in life-saving medical decisions, it is essential that the concept of informed consent aligns with their developmental stage. An emerging body of evidence emphasizes that due to their ongoing emotional development and inherent vulnerability, children might not fully grasp the repercussions associated with refusing life-saving medical treatments. Emotional volatility can skew their judgment, influenced by transient feelings of fear and apprehension. Hence, surrogate involvement in the decision-making process becomes vital to uphold informed consent and ensure the child's safety and well-being. Striking a balance between respecting a child's growing autonomy and recognizing their unique vulnerabilities is paramount. The involvement of surrogate decision-makers, such as parents or lega...