Informed consent in children and adolescents: REFUSAL OF CONSENT OR INCAPACITY (part 1)

In the event a minor refuses to consent to treatment that the physician believes to be in the minor’s best interests, it is unclear whether a physician can accept the refusal and still claim the minor has capacity. Sharpe notes that if a minor chooses to reject a clearly beneficial treatment, without a reasoned explanation, some providers may conclude that the minor does not fully appreciate the reasonably foreseeable consequences of his or her decision and is not mentally competent to make this decision.It is not clear whether the courts would support this position in the case of young people. They would not when considering adults. In Ontario, the law has progressed significantly from the days where a patient’s refusal of treatment considered in that person’s best interests was determinative of their incapacity. It remains to be discovered whether courts would apply special rules to young people here.

In Re LDK; CAS of Metropolitan Toronto v KAndK, a 12-year-old girl had leukemia. Both the child and her parents, who were Jehovah’s Witnesses, refused chemotherapy treatment which included blood transfusions. The judge found that while the child was rejecting the treatment on religious grounds, she was also basing her refusal on the suffering she had seen in other minors who had undergone chemotherapy. The judge did not comment directly on the child’s right of refusal. However, he commented on her wisdom, maturity and courageous nature and held that the child made a reasoned decision based on all available information, and he upheld her (and her parents’) treatment refusal. This case suggests that even a mature child of 12 would have the right to give an informed refusal to treatment. Buy cheap noroxin

This entry was posted in Children and adolescents and tagged Capacity to consent, Common law, Informed consent, Minors.