Morton Wendy J, Westwood Michael
Biomedical Ethics Unit, Faculty of Medicine, McGill University.
Adolescent Medicine and Gynaecology Programme, Montreal Children's Hospital, Montreal, Quebec.
Paediatr Child Health. 1997 Sep;2(5):329-333. doi: 10.1093/pch/2.5.329.
Confusion persists about when a minor can give informed consent to medical treatment. Physicians may be hesitant to treat minors, even as adolescents, without first obtaining parental or guardian consent for fear of being sued for battery or negligence. However, the common law in Canada is clear that a minor can give informed consent to therapeutic medical treatment, provided heorshe can understand the information regarding the proposed treatment and can appreciate the attendant risks and possible consequences. Courts have accepted that there is no precise age at which a minor can be presumed to have the capacity to give informed consent. Each minor must be individually assessed to determine whether he or she possesses the requisite maturity and level of understanding to comprehend the nature, benefits and risks of the proposed treatment. The responsibility for determining a minor's capacity rests with the physician or another health care provider who is seeking to obtain the informed consent. In the event that legal action is taken against the physician on the grounds the minor lacked the capacity to give informed consent, the court must be satisfied that the minor did have sufficient capacity. Examples of cases where the physician was sued by either the minor or the minor's parents are included. In addition, an overview of existing provincial legislation dealing with minors and informed consent is provided.
对于未成年人何时能够对医疗治疗给予知情同意,仍然存在困惑。医生可能会犹豫是否在未首先获得父母或监护人同意的情况下治疗未成年人,即使是青少年,因为担心被起诉犯有殴打罪或过失罪。然而,加拿大的普通法明确规定,未成年人可以对治疗性医疗给予知情同意,前提是他或她能够理解有关拟议治疗的信息,并能够认识到随之而来的风险和可能的后果。法院已经认可,不存在一个可以推定未成年人有能力给予知情同意的确切年龄。必须对每个未成年人进行单独评估,以确定他或她是否具备必要的成熟度和理解水平,以理解拟议治疗的性质、益处和风险。确定未成年人能力的责任在于寻求获得知情同意的医生或其他医疗保健提供者。如果以未成年人缺乏给予知情同意的能力为由对医生提起法律诉讼,法院必须确信该未成年人确实有足够的能力。文中包含了未成年人或其父母起诉医生的案例示例。此外,还提供了现有省级立法中关于未成年人和知情同意的概述。