Adolescent decision-making in Canadian medical contexts: Integrating neuroscience and consent frameworks

• Published in: Paediatrics & child health 2018-09, Vol.23 (6), p.374-376
• Main Authors: Schwartz, Yael, Williams, Tricia S, Roberts, Samantha D, Hellmann, Jonathan, Zlotnik Shaul, Randi
• Format: Article
• Language: English
• Subjects: Brain research; Clinical decision making; Commentaries; Decision making; Informed consent; Pediatrics; Right to die; Teenagers
• ISSN: 1205-7088; 1918-1485
• DOI: 10.1093/pch/pxy037

The primary objective of this commentary is to integrate current neuroscientific research on brain development during adolescence, with existing consent frameworks that do not designate a minimum age for eligibility to consent to, or refuse medical treatment. To reach this objective, the three consent frameworks used in health care settings are outlined: age-based framework; mature minor framework and capacity-based framework. This commentary draws on the Canadian health care system specifically to consider consent frameworks that grant young people with decision-making capacity. Next, a brief review of adolescent brain development findings is presented, particularly pertaining to the decision-making capacity of young people within medical contexts. Ultimately, the question of whether the stage of a young person's brain development impedes their capacity to consent to, or refuse medical treatment is addressed. This commentary provides reassurance as to the compatibility between capacity-based and mature minor frameworks to consent to treatment with current neuroscientific understanding of adolescent brain development.