Allowing Adolescents to Make Life-and-Death Decisions about Themselves: Rights and Responsibilities of Adolescents, Families, and the State

There is consensus among scholars writing in bioethics, medicine, and the law, that adolescents ought to participate in health care decision making about themselves. There is less agreement on what adolescent 'participation' means and about the range of health care decisions that adolescents can and should make, especially whether adolescents should be able to have ultimate authority over life-and-death decision making about themselves. This dissertation argues that adolescents should not be allowed to exercise such authority in the life-and-death decision making setting. A current, misconstrued 'respect' for adolescent autonomy is not justified by our inadequate understanding of decision making capacity, especially for adolescents who are in danger of making medical decisions that may greatly impact their future. Deliberation ought to be guided by a triadic approach that incorporates the interests, roles, and responsibilities of parents, health care providers, and the adolescent in a therapeutic alliance focused on beneficence to the adolescent patient.

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