Assessing an Adolescent's Capacity for Autonomous Decision-Making in Clinical Care

Michaud, Pierre; Blum, Robert W.; Benaroyo, Lazare; Zermatten, Jean; Baltag, Valentina

doi:10.1016/j.jadohealth.2015.06.012

Cited by 45 publications

(40 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In countries where adolescent consent is determined by provider discretion, with the exception of the United Kingdom (England) and France, there is no evidence of legal guidance for providers to systematically assess an adolescent's ability to consent or determine parental autonomy . Although there has been an increase in professional guidance for providers to assess an adolescent's ability to consent to clinical care and PrEP, it remains unclear if this guidance has led to an increase in adolescent PrEP provisions . Nevertheless, new language should be added to current minor consent laws with consideration of the multilevel vulnerabilities (e.g.…”

Section: Resultsmentioning

confidence: 99%

Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States

et al. 2019

View full text Add to dashboard Cite

Introduction Youth under the age of 25 are at high risk for HIV infection. While pre‐exposure prophylaxis (PrEP) has the potential to curb new infections within this population, it is unclear how country‐specific laws and policies that govern youth access to sexual and reproductive health (SRH) services impact access to PrEP. The purpose of this review was to analyse laws and policies concerning PrEP implementation and SRH services available to youth in countries with a high HIV incidence. To the best of our knowledge this is the first systematic assessment of country‐level policies that impact the availability of PrEP to adolescent populations. Methods We conducted a review of national policies published on or before 12 June 2018 that could impact adolescents’ access to PrEP, SRH services and ability to consent to medical intervention. Countries were included if: (1) there was a high incidence of HIV; (2) they had active PrEP trials or PrEP was available for distribution; (3) information regarding PrEP guidelines were publicly available. We also included a selected number of countries with lower adolescent HIV incidence. Internet and legal database searches were used to identify policies relevant to adolescent PrEP (e.g. age of consent to HIV testing). Results and Discussion Fifteen countries were selected for inclusion in this review. Countries varied considerably in their respective laws and policies governing adolescents’ access to PrEP, HIV testing and SRH services. Six countries had specific polices around the provision of PrEP to youth under the age of 18. Five countries required people to be 18 years or older to access HIV testing, and six countries had specific laws addressing adolescent consent for‐ and access to‐ contraceptives. Conclusions Adolescents’ access to PrEP without parental consent remains limited or uncertain in many countries where this biomedical intervention is needed. Observational and qualitative studies are needed to determine if and how adolescent consent laws are followed in relation to adolescent PrEP provisions. Intensified efforts to amend laws that limit adolescent access to PrEP and restrict the establishment of national guidelines supporting adolescent PrEP are also needed to address the epidemic in this group.

show abstract

Section: Resultsmentioning

confidence: 99%

Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States

et al. 2019

View full text Add to dashboard Cite

show abstract

“…It often requires individualised assessments of the competence of adolescents to make autonomous decisions about their health. 230 Access to broadband and digital technology platforms such as Massive Open Online Courses offer exceptional opportunities to build competency in health-care professionals but face-to-face training will still be required. 231 …”

Section: Actions For Healthmentioning

confidence: 99%

Our future: a Lancet commission on adolescent health and wellbeing

et al. 2016

View full text Add to dashboard Cite

“…Emancipated minors and mature minor doctrines are exceptions to the age of majority statutes, whereby adolescents are legally enabled to make health care decisions for general medical care, usually for specific situations and conditions. Mature minor doctrines vary widely across countries, and age limits for consenting rights also vary considerably across countries and states . For adolescents with cancer, mature minor doctrines have been inconsistently applied in cases of refusal of recommended cancer therapy.…”

Section: Decision‐making Considerationsmentioning

confidence: 99%

Ethical issues in the care of adolescent and young adult oncology patients

Sisk

Canavera

Sharma

et al. 2019

Pediatric Blood & Cancer

View full text Add to dashboard Cite

The diagnosis and treatment of cancer leads to short‐term and long‐term challenges for every patient. This is especially true for adolescents and young adults (AYAs) with cancer who strive to gain independence, autonomy, confidence, and social status while developing into adulthood. In this article, we review prominent ethical issues in AYA oncology that are related to autonomy, shared decision‐making, care refusal or abandonment, end‐of‐life care, truth telling, and fertility preservation. Clinicians should recognize that AYA patients develop at their own pace; the onus lies with clinicians to determine the patient's interests, values, maturity, and desire to participate in decision‐making.

show abstract

Assessing an Adolescent's Capacity for Autonomous Decision-Making in Clinical Care

Cited by 45 publications

References 32 publications

Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States

Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States

Our future: a Lancet commission on adolescent health and wellbeing

Ethical issues in the care of adolescent and young adult oncology patients

Contact Info

Product

Resources

About