The Ethical Complexity of Medical Decision Making in the Adolescent Oncology Patient

Author:

Nash Ariel Paige1,Harden Avis1ORCID,Sheth Rachna Kalapi1

Affiliation:

1. MD Anderson Children’s Cancer Hospital, Houston, TX 77030, USA

Abstract

Adolescent Medical Decision Making (aMDM) is frequently discussed but presents a significant challenge in practice, especially in cases of adolescents with life threatening or life limiting illnesses. In this paper, we present a case that explores the importance of aMDM, the difficulties for providers when engaging adolescents in these discussions, and how certain skills may be incorporated into pediatric practice. Literature suggests that patients of this age group, while being legally without capacity, have meaningful insights into their care. However, unless physicians feel comfortable and competent engaging adolescents in a manner that honors their developmentally appropriate understanding of their illness, these insights can be lost.

Publisher

MDPI AG

Reference22 articles.

1. Nortjé, N., and Bester, J.C. (2022). Parental Permission, Childhood Assent, and Shared Decision-Making. Pediatric Ethics: Theory and Practice, Springer International Publishing.

2. Informed consent in decision-making in pediatric practice;Katz;Pediatrics,2016

3. Nortjé, N., and Bester, J.C. (2022). Caring for Adolescents: Unique Ethical Considerations. Pediatric Ethics: Theory and Practice, Springer International Publishing.

4. Nortjé, N., and Bester, J.C. (2021). Parental Refusal of Beneficial Treatments for Children: Ethical Considerations and the Clinician’s Response. Pediatric Ethics: Theory and Practice, Springer.

5. Takeuchi, Y., and Ambresin, A.-E. (2021). Assessing and Supporting Adolescents’ Capacity for Autonomous Decision-Making in Health-Care Settings A Tool for Health-Care Providers, World Health Organization.

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