Adolescent Refusal of Life-Sustaining Treatment

Patricia is 17 and has taken an overdose of paracetamol. She has been rushed to the Accident and Emergency department and doctors tell her that she needs urgent treatment; otherwise, she is at risk of permanent liver damage or death. Patricia refuses, she says her life is awful and she does not want to live anyway. She has been diagnosed with emotional intensity disorder and has had a recent brief admission under the Mental Health Act, although she was discharged last week.

John is 16 and has been involved in a road traffic accident. He needs urgent treatment, which would include blood products. He tells the doctors that he is a practicing Jehovah’s Witness and, in all circumstances, he refuses blood products in any form.

Joshua is 15. Over the past 3 years he has been in and out of hospital for treatment of leukemia. Unfortunately, following a check-up, the doctors tell him that he now needs further aggressive chemotherapy. Without treatment his prognosis is poor, and he is likely to die within 6 months. Joshua has had enough. He does not want to go into hospital again nor receive any more treatment, which he knows through experience makes him feel very sick. He wants to be at home with his family and have a peaceful end to his life. The doctors consider that with this treatment he will have a 30% chance of remission in 5 years.

• Can a minor refuse medical treatment?
• Does it make a difference if they are 15 or 17 years old?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

Clinical Ethics and Law, Second edition. Carolyn Johnston, Penelope Bradbury, Series editor: Janice Ryme