title: Adolescent refusal of lifesaving treatment: are we asking the right questions?
abstract: In life-threatening situations, whether and under what conditions a minor should be allowed to refuse a lifesaving intervention is an important question. This article addresses the issue of whether adolescents, as a rule, possess capacity of sufficient quality that it should be respected even in the case of life-altering medical decisions. After reviewing the traditional approach to determining when adolescents should have their decisions respected, an approach that focuses on establishing capacity under a traditional informed consent model, the article reviews our evolving understanding of adolescent brain development and explores the implications for adolescent decision-making capacity. The author argues that a demonstration of understanding and mature reasoning abilities is not sufficient to establish decision-making capacity and that most minors do not possess fully mature decision-making capacity. Finally, the author suggests an approach to adolescent decision-making that is more reflective of the developing state of the adolescent brain.
authors: University of Washington School of Medicine, Seattle, Washington, USA. diek@u.washington.edu
authors: Douglas S
authors: DS
authors: Diekema
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D001921:Brain / Q000254:growth & development; D003142:Communication; D032882:Comprehension; D003657:Decision Making; D006801:Humans; D010817:Physician-Patient Relations; D016312:Treatment Refusal / Q000941:ethics / Q000331:legislation & jurisprudence / Q000523:psychology*