Ethics in Ontario re: What constitutes as a minor

[lostintime]

I know the doctor is supposed to judge based on child's maturity. But I mean most docs aren't child psychologists/teachers/specialized social workers. I'm sure they have general common sense and experience, but I think there should be SOME line drawn rather than letting the doctor call all the shots.

 

For instance, the rule doesn't have to be hard/fast, but I would say MOST 12 year olds should still be considered as minors. Sure, there are mature ones, but I think there has to be SOME kind of standard and not just "let the doctor decide" through perhaps only 1 opportunity of like a 30 min visit.

 

How do doctors feel about this in general? Of course I have no experience, but I would imagine it would be a pretty difficult ethical decision to make when given 30 min to get to know a child and see how "mature" they are.

[mrgreek]

you could consider if they understand in what they are saying, if their reasoning is like that of an adult, would you treat him or her like an adult? If you wouldnt feel comfortable depending on the scenario, or if you think ppl would question you, why not ask a colleague what he or she would do, grab one from the hallway or something.

[Satsuma]

When you say "minors"...are you referring to the ability to give informed consent?

 

Informed consent really does need to be done on a case by case basis. Age is not the determining factor in being considered competent to make decisions. Furthermore, a person can be deemed competent to make some decisions in one area but not decisions in another area....so being competent to make informed decisions is not black and white regardless of age.

 

As the physician you need to be able to judge whether your patient understands/recognizes their illness/diagnosis and also can appreciate the consequences of undergoing treatment or not undergoing treatment/testing...whatever it is you are suggesting. There is no magic way to do this. You do it with every patient you are interacting with regardless of age.

 

You don`t need to be a child-psychologist, teacher or social worker to determine if your pt is competent. You can always ask for a second opinion if the case is questionable.

 

Remember that in Ontario where there is no minimum stated age to give informed consent for a treatment....there is a minimum age to refuse. So your 12 year old could in theory accept a treatment if you felt he/she was capable of informed consent....however, that same 12 year old would not be able to refuse treatment....you would need to contact the guardians.

[lostintime]

Oh thanks for the insight. I didn't realize there was a difference between informed consent and refusal of treatment (time to brush up on the ethics). So is the legal age for refusal of treatment 12 then? I've been trying to find the document with that info, but no such luck =(

[SpanishFly]

 

Remember that in Ontario where there is no minimum stated age to give informed consent for a treatment....there is a minimum age to refuse. So your 12 year old could in theory accept a treatment if you felt he/she was capable of informed consent....however, that same 12 year old would not be able to refuse treatment....you would need to contact the guardians.

 

Really? thats interesting, I didn't know there was a difference either...can you give me a source for that? (not that I don't believe you, I just want to read about it )

[mbene085]

Really? thats interesting, I didn't know there was a difference either...can you give me a source for that? (not that I don't believe you, I just want to read about it )

 

I'm pretty sure it's because a treatment suggested by a doctor is, in the doctor's educated opinion, the option that is in the patient's best interest. So consenting to the treatment is agreeing with the medical professional.

 

Meanwhile, refusing a treatment means refusing the course of action that the doctor believes is in your best interest. Letting a child say no to, for example, a spinal tap because they're afraid of the needle would be completely negligent if they suspect the child is suffering from, say, bacterial meningitis. You'd be letting the child make a decision that could very well lead to their death.