Can children make their own healthcare decisions?

When equipped with enough information, some adolescents (ages 13 to 16) can make health care decisions as well as adults.

According to an article published recently in The Journal of Clinical Ethics, “Correlates of Children’s Competence to Make Healthcare Decisions,” it’s important to include children in health care decision making as it fosters their developing ability to care for their own health. The article was written by a team of researchers that included Susan B. Dickey, Ph.D., R.N., associate professor of nursing in Temple University’s College of Health Professions. “We are interested in fostering children’s and adolescents’ developing ability to take care of their own health. Parents are equipped differently, from one family to the next, in their capacity to teach their children about good health and health care. It’s just like any form of development – most people can learn to read over time, one learns to take care of one’s body, especially when given opportunities to learn about health,” said Dickey.

When possible, it’s best to engage all family members in the decision-making at hand. But sometimes, adolescents may urgently need services for problems they don’t want to share with their parents, such as pregnancy, sexually transmitted diseases, substance abuse or mental illness. In such cases, mandating parental involvement could jeopardize the health and well being of the adolescent. The researchers measured older children’s (11-12 years) and adolescents’ (13-16 years) ability to make informed decisions about medical treatment. One group of children had had previous experience with the health care system.

“Most striking to us was that when given all of the information, adolescents made decisions similarly to adults, supporting previous research on the issue. The younger subjects, however, were not completely competent to make good health care decisions, although there were trends in the data that suggested that these skills were developing,” said Dickey.

Dickey, a board appointed member of the American Nurses Association Advisory Committee on Ethics and Human Rights, is an expert in health care decisions by school-age children and adolescents. She has consulted extensively in cases involving children and health care.