Human Exceptionalism

Should 14 Year-Old Make Life and Death Medical Decisions?

At what age should children be allowed to make their own medical decisions? It seems to me, that just as children can’t sign contracts or vote, they shouldn’t have the final say in whether they receive medical care? But in Washington, a court permitted a 14-year-old to refuse a blood transfusions for religious reasons, which resulted in his death. From the story:

When Skagit County Superior Court Judge John Meyer came to work he expected to be hearing a few small matters. Instead, he made a decision in a case that he said has “perhaps more profound interest and implication than any matter I have ever heard on the bench.”

Meyer decided Wednesday to allow 14-year-old Dennis Lindberg of Mount Vernon to refuse blood transfusions–based on his religious beliefs–in his fight against leukemia. Lindberg died later that evening…

Lisa Kelly, director of the Children and Youth Advocacy Clinic at the UW Law School, said that while courts are listening more to adolescents, there’s also the understanding that teens “have a developmental trajectory that is not yet like an adult’s.”

That tension is reflected in state law as well. For instance, those under 18 generally cannot receive health care without a parent’s consent, though there are exceptions, such as in cases concerning birth control and abortion.

“It’s a gray area when you have a 14-year-old making the decision,” said Thomas McCormick, senior lecturer emeritus at the UW School of Medicine. Such instances need to be taken on a case-by-case basis, ethicists say, after conversations with the patient to assess his maturity, whether his beliefs are well grounded and arrived at without coercion, and whether he truly understands the consequences of his decision.

Of some interest in this regard, what if Washington legalizes assisted suicide as a so-called medical treatment next year? (Booth Gardner, the very rich former governor, intends to try and buy such a law.) No doubt the law, if passed, will require adulthood. But if the above case applies, if fourteen year-olds can accept and refuse treatment, how can they be denied a poison prescription if they are an otherwise qualified patient?

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