The capacities of minors to exercise voluntariness in medical treatment decisions

The legal standard for informed consent to medical treatment requires that the consenter be informed, competent, and acting voluntarily. The voluntary requirement of a valid consent was investigated by comparing forty 9- and 10-year-old children and forty 14- and 15-year-old adolescents (both generally presumed to be incapable of voluntary consent) with 47 young adults ranging in age from 21 to 25 (legally presumed to be deciding voluntarily) on responses to three hypothetical medical decision vignettes. The degree of parental influence was varied within each vignette to study the salience of parental influence in medical decision making. In two of three medical decision vignettes, most participants were deferent to parental wishes and few differences were found between children, adolescents, and young adults in their responses to parental influence. Differences between age groups were found in response to a kidney donation vignette. Children were significantly more likely to defer to parents than either adolescents or young adults. Adolescents were more likely to defer to parents than young adults, although this finding only approximated statistical significance. Implications of these findings for legal authorities, social policy makers, and families are discussed.