Department is Paediatric Critical Care, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Philosophy, McMaster University, Hamilton, Ontario, Canada.
J Med Ethics. 2020 Jun;46(6):355-359. doi: 10.1136/medethics-2019-105702. Epub 2020 Feb 14.
Infants are unable to make their own decisions or express their own wishes about medical procedures and treatments. They rely on surrogates to make decisions for them. Who should be the decision-maker when an infant's biological parents are also minors? In this paper, we analyse a case in which the biological mother is a child. The central questions raised by the case are whether minor parents should make medical decisions on behalf of an infant, and if so, what are the limits to this decision-making authority? In particular, can they refuse treatment that might be considered best for the infant? We examine different ethical arguments to underpin parental decision-making authority; we argue that provided that minor parents are capable of fulfilling their parental duties, they should have a right to make medical decisions for their infant. We then examine the ethical limits to minor parents' decision-making authority for their children. We argue that the restricted authority that teenagers are granted to make medical decisions for themselves looks very similar to the restricted autonomy of all parents. That is, they are permitted to make choices, but not harmful choices. Like all parents, minor parents must not abuse or neglect their children and must also promote their welfare. They have a moral right to make medical decisions for their infants within the same 'zone of parental discretion' that applies to adult parents. We conclude that adult and minor parents should have comparable decision-making authority for their infants.
婴儿无法自己做出医疗程序和治疗的决定或表达自己的意愿。他们依赖代理人代表他们做出决定。当婴儿的亲生父母也是未成年人时，谁应该成为决策者？在本文中，我们分析了一个亲生母亲是未成年人的案例。该案例提出的核心问题是未成年父母是否应该代表婴儿做出医疗决定，如果是，这种决策权的限制是什么？特别是，他们能否拒绝可能被认为对婴儿最有利的治疗？我们考察了支持父母决策权的不同伦理论点；我们认为，只要未成年父母能够履行其父母责任，他们就应该有权为其婴儿做出医疗决定。然后，我们考察了未成年父母为其子女做出决策的伦理限制。我们认为，青少年被赋予的为自己做出医疗决定的有限权力与所有父母的有限自主权非常相似。也就是说，他们可以做出选择，但不能做出有害的选择。与所有父母一样，未成年父母不得虐待或忽视其子女，还必须促进其福利。他们在适用于成年父母的“父母酌处权范围”内，有权为其婴儿做出医疗决定。我们的结论是，成年父母和未成年父母应为其婴儿拥有可比的决策权。
