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Erschienen in:
19.03.2024 | EDITORIAL
Empowering young voices: navigating the complexities of minors in healthcare decisions
Erschienen in: European Journal of Pediatrics | Ausgabe 6/2024
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The inclusion of children in healthcare decisions is a crucial element that requires attention to ethical, legal, and psychological considerations (Table 1). Balancing autonomy with welfare interests and parental involvement is a significant challenge in pediatric healthcare ethics. Even decades after their adoption, the central themes of the United Nations Convention on the Rights of the Child “Provision, Protection and Participation” are the foundation of many legislations regarding children or their representation. The translation of these concepts to healthcare access and medical decision-making should lead towards the recognition of a child as a rights holder with a progressively evolving ability and even capacity to make their own decisions [1]. Progressive legal frameworks and ethical guidelines direct physicians towardzs inclusive medical decision-making for minors [2]. Yet, this “ethical ideal” is not always realized in clinical practice.
Table 1
Summarizing the complexity of involving minors in healthcare decisions across various dimensions
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Dimension
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Key aspects
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|---|---|
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Ethical considerations
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• Respecting a minor’s autonomy in healthcare decisions
• Ensuring their well-being and minimizing harm
• Promoting fairness in healthcare access and treatment
|
|
Legal framework
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• Age of Consent varies by region, affecting decision-making autonomy
• Legal protections and rights guide decision-making processes
|
|
Psychological and developmental factors
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• Cognitive development impacts decision-making abilities
• Emotional maturity influences decision-making processes
• Social influences play a role in decision-making
|
|
Medical context
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• The nature of the medical decision matters
• Risk–benefit analysis is crucial in decision-making
• Urgency of the medical decision can affect decision-making processes
|
|
Cultural and societal norms
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• Family dynamics influence decision-making
• Cultural values shape healthcare decisions
• Societal expectations impact decision-making
|
|
International variations
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• Europe and other regions have varying legal approaches to adolescent healthcare decisions
• Inconsistencies in legal frameworks exist across countries
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|
Challenges and considerations
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• Balancing empowerment of minors with responsible decision-making
• Assessing maturity levels to determine decision-making capacity
• Open communication between healthcare professionals, minors, and families is essential
• Ethical dilemmas may arise in decision-making processes
|