Medical Treatment Decisions for Adolescents

Week 3
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Tutorial Questions
TQ 3.1: Mutcherson
The question of when an adolescent can make an independent decision regarding medical treatment has always been problematic. This problem has been compounded further by contradictory statutes and research findings. According to Mutcherson (2005), extenuating circumstances grant adolescents freedom to decide their treatment preferences. 
If an adolescent finds the idea of involving a parent disagreeable and, therefore, rejects it, the healthcare provider should respect those wishes. Such mainly happens in pregnancy, STIs, substance abuse, and mental health treatment. A minor worried about severe reprisals from the parents because of their misdemeanors may not want to involve them in treatment. When such minors seek confidentiality, and their conditions do not pose a severe health threat, their wish should be granted.
An adolescent may also be given autonomy if the parent has some form of incapacity, such as lack of maturity, or is mentally incapacitated. A minor may raise concerns regarding the mental well-being of their parents. They may argue that due to an unsound mind, the parents may be incapable of making rational decisions. When such an argument is raised, it is the prerogative of the health provider to verify the claims. If they are adjudged as veritable, the health provider would have to weigh whether to follow the preference of a mentally challenged adult or a concerned minor.
Further, if an adolescent is financially independent and is in a position to cater for treatment, a healthcare provider can offer the treatment without consulting the parents. According to the Video Transcript, emancipated youths in most states have the same rights as adults. One aspect of emancipation is when a minor is self-supportive. It would be illogical to deny consent to a minor who can comfortably cater for their medical services. This is especially so if the situation is not an emergency. 
The other circumstance that can afford an adolescent the freedom to decide is when the adolescent has conflicting religious beliefs from the parents. If the parents reject treatment based on religious affiliations, an adolescent can be allowed to determine otherwise. Medical care is considered one of the essential basic needs (Linnard-Palmer & Kools, 2004). Therefore, it would beat reason to allow religious beliefs to override this fact. The most logical thing to do in such a situation would be to act in the best interests of the minor.
Last but not least, if the adolescent lives away from their parents and shows competence, their requests can be granted. In the same vein and according to the Video Transcript, if a minor is married, they can make their own decisions. A married minor is regarded as being emancipated and has, therefore, got the same rights as an adult. One pertinent presumption is that they are competent enough to understand what is best for them.
TQ 3.2: California and Maryland Statutes:
California and Maryland statutes differ to some extent when it comes consent for treatment by minors. In Maryland, a minor's capacity to consent to treatment is similar to an adult's if they are a child's parent or are married. In the case of emergency treatment, a minor's capacity to consent is the same as an adult's if the physician adjudges that their life would be severely affected if treatment is delayed to obtain another person's consent. In California, minors may consent to treatment if they are aged 15 years or older, living separately from their parents or guardians, and managing their financial affairs (Cal. Fam. Code §§ 6922). Therefore, a minor aged 15 years may not consent to treatment in Maryland but may do so in California.
When it comes to mental health, in California, a minor aged 12 years or older can consent to treatment if the attending professional adjudges them to be mature enough to partake intelligently in outpatient services (Cal. Fam. Code §§ 6924). Another condition for consent in California is that the failure to provide mental health treatment would present serious harm to the minor or others. In Maryland, a minor aged 16 years or older can consent to mental health treatment as an adult (Maryland.gov, n.d.). However, the minor cannot refuse treatment when the guardian or parent has given consent. Therefore, for mental health, consent between the two states differs in terms of the age of the minor and the availability of parental consent.
TQ 3.3: Parham v. J.R.
The majority of judges, in this case, concluded that the Constitution does not require a judicial hearing before a minor is committed to a mental health hospital. Their conclusion relied on the presumption of the Constitution that parents usually act in the child's best interests. The judges also felt that one of the fundamental roles of parents is to recognize symptoms of illnesses and, thereafter, seek appropriate medication (LexisNexis, 2022). The majority also relied on the presumption that parents are endowed with what a child lacks in terms of maturity and experience. They also argued that they have sound judgments that are requisite in making critical and difficult decisions.
According to the majority, pre-admission commitment could be detrimental in several ways. To begin with, the hearing might impose unnecessary procedural obstacles that may discourage the mentally ill or their families from seeking help (United States Supreme Court, 1979). The court, therefore, contended that the resources used in convening such hearings could be used in other worthwhile undertakings. A minor being forced into a mental facility may have every reason to believe that the parents want to get rid of them. According to the Video Transcript, they may feel that they are being sanctioned for acting unpleasantly. The minors may, further, feel that their freedom is being tampered with by sending them to a mental facility. They may not understand that their parents are well intended and believe they are being unfairly targeted due to their condition. This misunderstanding may have far-reaching implications on both sides, straining the relationship between a parent and child.
Essentially, it would create unnecessary conflict and tension between the two parties. The tension created by an adversarial hearing might make it difficult for the minor to return home, thereby interfering with the family unit. In addition, they argued that it would infringe on the Constitution's presumption of the parent's positive intentions. The approach would also place the competence of parents in doubt. In situations where a minor has severe psychiatric problems therefore, having a high risk of suicide or posing a threat to other people, a parent may feel that the most plausible thing is to have the minor admitted (Pety So et al., 2021). The parent would do so with the conviction that it would avert unnecessary destruction or losses. If such a decision is challenged, the parents might feel that their competence has been grossly disregarded. This might be quite distressing because the parents' world is already turned upside down by the minor's mental condition. In a word, they would be inclined to feel that their fundamental right over their kids is being overlooked at the most critical of times. Given the dire situation, such parents would, conventionally, expect their decisions to be granted without a demur.
TQ 3.4: Parham v. J.R.
Judge Brennan agreed that a pre-commitment hearing for minors before mental hospital admission was unnecessary. This was because he understood that it was consistent with the Constitution’s presumptio...