minors rights ? - drzena84

[ArchivalUser]

13. A 16-year-old boy and his mother come to the office because the mother is concerned that her son may have a drug problem. You have treated him in the past for mild intermittent asthma, and he currently uses an albuterol inhaler prior to exercise. You last saw him 1 year ago for a sports physical examination. At that time, he admitted to drinking alcohol on the weekends. He also admitted to marijuana use but had planned to quit using both before track season started. The mother says that her son now seems disinterested in school and other activities in which he was previously engaged. He has quit the track team, has become irritable, and he has a new set of friends whom his mother dislikes and describes as "druggies." She acknowledges that the boy's father, from whom she is divorced, has an alcohol abuse problem. The boy's older brother abused cocaine for 2 years but is now in a drug rehabilitation program. Prior to interviewing and examining the patient, the mother pulls you aside and asks you to test her son for drugs without informing him. Which of the following is the most appropriate response?

A) Agree to do toxicologic screening but review the test results with the patient before giving the results to the mother
[B) Agree to do toxicologic screening only if, after discussing it with the patient, he grees to the test]
C) Agree to do toxicologic screening without the patient's knowledge per his mother's request
D) Decline to do toxicologic screening stating that you do not want to get caught between her and her son
E) Decline to do toxicologic screening unless under a court order

I understand that this is because the issue is about drug abuse, but what if the mother request a test about somthing else( some disease running in the family) and the kid refuse the test ? do we do it or no?

[ArchivalUser]

Answer is B

For your other question read "Mature Minor" "Emancipated Minor"

http://jlgh.org/content/upload/AssetMgmt...i2_A06.pdf

Is a good read

http://www.nursingcenter.com/prodev/ce_a...tid=739795


I think in most cases if minor is refusing treatment or testing cases usually head to court for decision making

Read below
http://www.allbusiness.com/legal/legal-s...931-1.html

[ArchivalUser]

Interesting question. I tried to look it up. Apparently I couldn't find the test. My personal opinion, if it is a life threatening condition, no need to get consent from anyone. If it is a regular test, we need to get consent from the parent but you can't force a 16 year old to have the test done. Question must give us an option, explain to the family why the test is needed, ask the minor why he is refusinf it blah blah. Consent is for the legal issues from a professional's stand point that a minor cant just show up at a clinic and ask for a laproscopy. He must have consent from the parent. But at the same time, a parent cant ask a physician to do a test on a kid by holding him down in the clinic and getting blood out of his veins. When a kid and his parents show up at the clinic, we assume this is what both of them want. You can't force a 16 year old to have a blood draw. You need a court order to do that.

This is what I think I will do in my practice. I dont know what are the guidelines though.

[ArchivalUser]

Yep pretty much what those articles are saying, courts do get involved if the minor is not emancipated. In ER consent is implied in life threatening situations. Similarly even though parents are legal decision makers they cannot withhold life saving treatment from minors because THEY dont believe in them. Case in point the HL patient 13 year old about 1.5 year ago whose mom stopped his Chemo even though the patient was getting better and bright recovery chances but she started treating him with plants and organic things and stopped Chemo. Court order was issued to continue chemotherapy.....I do not remember what state was it.

[ArchivalUser]

@ drstethoscope
thanks for the opinions and links.

@2ndtime i think i will do the same in my practice.

[ArchivalUser]

Ans. B

Criteria for emancipated minor ( from dr.reds Ethics review)

The following are the categories of minors authorized to consent to medical care
emancipated minors (sometimes defined as those who are married, who are pregnant, who are parents, who have served in armed forces, are living apart and financially independent from their parents) :

married minors;
minors in the armed forces;
mature minors;
minors living apart from their parents ( if older than 13 yrs) ;
high school graduates;
pregnant minors
minor parents.

The idea behind this is that because these minors are no longer under effective parental supervision, parental consent is not a sensible precondition to accessing care.


SERVICES WHICH DO NOT NEED PARENTAL CONSENT :

There are some health services for which any minor can give consent. The various services for which minors are authorized to give consent in one or more states in the USA are: • emergency care; • prenatal care; • contraceptive services; • abortion; • diagnosis or treatment of venereal or sexually transmitted diseases; • diagnosis or treatment of reportable, infectious, contagious or communicable diseases; • HIV/AIDS testing or treatment; • counseling or treatment for drug- or alcohol-related problems; • collection of medical evidence or treatment for sexual assault; and • in- or outpatient mental health services. 


NOTE : If a patient who is a minor requests termination of pregnancy, advice on contraception, or treatment of sexually transmitted diseases without a parent's knowledge or permission, the physician may wish to attempt to persuade the patient of the benefits of having parents involved, but should be aware that a conflict may exist between the legal duty to maintain confidentiality and the obligation toward parents or guardians  Information should not be disclosed to others without the patient's permission . In such cases, the physician should be guided by the minor's best interest in light of the physician's conscience and responsibilities under the law.

[ArchivalUser]

Awesome answer Misshyd