title: Braving difficult choices alone: children's and adolescents' medical decision making.
abstract: OBJECTIVE
  What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them.
  
  
  METHODS
  Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice.
  
  
  RESULTS
  Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses.
  
  
  CONCLUSIONS
  Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process.
authors.affiliation: Max Planck Institute for Human Development, Berlin, Germany.
authors.forename: Azzurra
authors.initials: A
authors.lastname: Ruggeri
authors.affiliation: University of Plymouth, Plymouth, England.
authors.forename: Michaela
authors.initials: M
authors.lastname: Gummerum
authors.affiliation: University of Plymouth, Plymouth, England.
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Hanoch
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002755:Choice Behavior; D003657:Decision Making; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D026684:Personal Autonomy; D011795:Surveys and Questionnaires
references.citation: J Pediatr Psychol. 1996 Aug;21(4):505-16
references.pmid: 8863460
references.citation: Univ Ill Law Rev. 1994;2:311-36
references.pmid: 11659988
references.citation: J Adolesc Health. 2010 Mar;46(3):265-9
references.pmid: 20159504
references.citation: Psychol Sci Public Interest. 2007 Nov;8(2):53-96
references.pmid: 26161749
references.citation: Health Educ Res. 2003 Feb;18(1):1-14
references.pmid: 12608680
references.citation: Child Dev. 1994 Aug;65(4):1147-62
references.pmid: 7956471
references.citation: Adolescence. 2003 Summer;38(150):343-58
references.pmid: 14560886
references.citation: Arch Dis Child. 2007 Nov;92(11):1015-9
references.pmid: 17954479
references.citation: Child Dev. 2003 May-Jun;74(3):783-800
references.pmid: 12795390
references.citation: Health Psychol. 2005 Jul;24(4S):S57-62
references.pmid: 16045420
references.citation: J Gen Intern Med. 2008 Oct;23(10):1708-12
references.pmid: 18665428
references.citation: J Gen Intern Med. 2006 Jun;21(6):618-22
references.pmid: 16808746
references.citation: J Adolesc Health. 2004 Dec;35(6):529.e1-6
references.pmid: 15581537
references.citation: JAMA. 2004 Nov 24;292(20):2516-8
references.pmid: 15562133
references.citation: Cognition. 2006 Jan;98(3):287-308
references.pmid: 16399266
references.citation: J Adolesc Health. 2007 Aug;41(2):208-10
references.pmid: 17659227
references.citation: Dev Psychol. 2004 Sep;40(5):764-75
references.pmid: 15355164
references.citation: JONAS Healthc Law Ethics Regul. 2007 Jul-Sep;9(3):100-4; quiz 105-6
references.pmid: 17728582