Assessing an Adolescent's Capacity for Autonomous Decision-Making in Clinical Care

Abstract The purpose of this article is to provide policy guidance on how to assess the capacity of minor adolescents for autonomous decision-making without a third party authorization, in the field of clinical care. In June 2014, a two-day meeting gathered 20 professionals from all continents, work...

Full description

Saved in:
Bibliographic Details
Published in:Journal of adolescent health 2015-10, Vol.57 (4), p.361-366
Main Authors: Michaud, Pierre-André, M.D, Blum, Robert Wm, M.D., M.P.H., Ph.D, Benaroyo, Lazare, M.D., Ph.D, Zermatten, Jean, h.c. Ph.D, Baltag, Valentina, M.D., M.Sc., Ph.D
Format: Article
Language:English
Subjects:
Adolescent
Adolescent Health - standards
Adolescent Health Services - standards
Assessment
Confidentiality
Decision Making
Development
Ethics
Humans
Informed Consent - standards
International Cooperation
Mental Competency - standards
Pediatrics
Psychology, Adolescent
Psychosocial
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract The purpose of this article is to provide policy guidance on how to assess the capacity of minor adolescents for autonomous decision-making without a third party authorization, in the field of clinical care. In June 2014, a two-day meeting gathered 20 professionals from all continents, working in the field of adolescent medicine, neurosciences, developmental and clinical psychology, sociology, ethics, and law. Formal presentations and discussions were based on a literature search and the participants' experience. The assessment of adolescent decision-making capacity includes the following: (1) a review of the legal context consistent with the principles of the Convention on the Rights of the Child; (2) an empathetic relationship between the adolescent and the health care professional/team; (3) the respect of the adolescent's developmental stage and capacities; (4) the inclusion, if relevant, of relatives, peers, teachers, or social and mental health providers with the adolescent's consent; (5) the control of coercion and other social forces that influence decision-making; and (6) a deliberative stepwise appraisal of the adolescent's decision-making process. This stepwise approach, already used among adults with psychiatric disorders, includes understanding the different facets of the given situation, reasoning on the involved issues, appreciating the outcomes linked with the decision(s), and expressing a choice. Contextual and psychosocial factors play pivotal roles in the assessment of adolescents' decision-making capacity. The evaluation must be guided by a well-established procedure, and health professionals should be trained accordingly. These proposals are the first to have been developed by a multicultural, multidisciplinary expert panel.
ISSN:1054-139X
1879-1972
DOI:10.1016/j.jadohealth.2015.06.012