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Children
Published in Yann Joly, Bartha Maria Knoppers, Routledge Handbook of Medical Law and Ethics, 2014
Common, or judge-made, law is the primary source of the ‘mature minor’ exemption to the requirement of parental permission (Slonina 2007). This doctrine allows clinicians under certain circumstances to rely on the consent of minors for clinical interventions, protecting clinicians from liability in the case of parents whose permission was not sought or of minors who subsequently want to disaffirm their prior consent to treatment. This doctrine is most often invoked in cases involving an older teen who has decision-making capacity and where the care provided was within the mainstream, met the standard of care, and was not high risk (English et al. 2010). Few states have specifically rejected this doctrine, but a small number of states have passed statutes essentially codifying the mature minor doctrine, allowing minors to give effective consent if they are above a certain age or have ‘sufficient intelligence to understand and appreciate the consequences of the proposed surgical or medical treatment or procedures’ (Arkansas Code Ann. § 20-9-602(7) 2010).6
Gillick
Published in Shaun D. Pattinson, Revisiting Landmark Cases in Medical Law, 2018
The retreat from Gillick in Re W has been cited with approval in many recent cases. In AC v Manitoba, the Supreme Court of Canada held that provincial legislation, which provided for children under the age of 16 to be treated against their will, was not in conflict with the Canadian Charter of Rights and Freedoms.112 Abella J, giving the principal judgment, examined Re W and noted that Canadian and international jurisprudence ‘have not generally seen the “mature minor” doctrine as dictating guaranteed outcomes, particularly where the consequences for the young person are catastrophic’.113 In X, the New South Wales Court of Appeal similarly cited Re W with approval and upheld a trial judge’s overruling of the refusal of blood products by a child of the Jehovah’s Witnesses faith.114 This was despite that child being only four months away from his eighteenth birthday and the trial judge considering him ‘a mature child of high intelligence’.115 The Court of Appeal reasoned that Gillick ‘does not diminish the scope of the parens patriae jurisdiction’.116 In Jamie, the Full Court of the Family Court of Australia took a contrasting approach to the relationship between Gillick and the parens patriae jurisdiction.117 The Family Court held that an 11-year-old child could consent to treatment for gender identity disorder on the basis that the court has no role to play ‘if the child is Gillick competent’.118 It is difficult to reconcile these two decisions of intermediate appeal courts.119 There is, at its core, legal debate about whether the parens patriae powers are triggered by minority or incompetent minority.
Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm
Published in The American Journal of Bioethics, 2019
The first stage of puberty (and hence the approximate time to begin puberty blockers) begins far younger than the age of legal majority (Selva 2017). Hence, we run into a dilemma if parents are insistent against such treatment. One potential solution, at least in the United States, is to appeal to what is known as the mature minor doctrine. This doctrine recognizes that some adolescents are wise beyond their years, and hence leaves room for these precocious children to make their own medical decisions when deemed sufficiently mature by the courts (Coleman and Rosoff 2013). However, this is not the solution I want to defend. While I have no issue with using this justification in some cases, I believe that transgender children have a right to treatment apart from any use of the mature minor doctrine, a right that is both universal and not dependent on the transgender child possessing a specific level of maturity. After all, not all transgender youth meet the requirements of a mature minor. Hence, if all transgender youth deserve access to PBT, it is best that we do so on different grounds. The justifying principles fit for this task are similar to principles used in the following two types of cases:Principles that justify taking a neglected child away from the home.Principles that justify performing a blood transfusion on children of Jehovah’s Witnesses.
RE: Ryan, Toomey, Diaz, and Russell (2018)
Published in Journal of Homosexuality, 2021
The potential-unintended consequences of banning therapies conducted by licensed therapists should also be considered. As noted by Sandley (2014), these consequences include an erosion of the mature minor doctrine (for adolescents), an increased reliance by parents and adult consumers on unlicensed and faith-based providers, and the establishment of a very weak standard of scientific support that could come to be used in the courts against other progressive causes such as women’s reproductive rights (i.e., purported psychological harms attributed to abortion).
Effects of an Intervention Program for Promoting Ethical Practices Among Pediatric Nurses
Published in Comprehensive Child and Adolescent Nursing, 2019
Adherence to the “Children’s right to be informed in a manner appropriate to age and understanding,” from Article 13 of the “Convention on the Rights of the Child” which was ratified by Japan in 1994, has been discussed in the context of medical practice. In Japan minor treatment statutes, known as the Mature Minor Doctrine, state that minors over the age of 16 with adequate decision-making and an understanding of their medical condition, are allowed the right to consent to minimally invasive treatment with parental permission.