Ethics and the teen patients

Abstract

Psychologists treating sick teenagers must decide how they should behave toward them. The question has a technical and a moral dimension. First, the psychologist must decide whether he has the competencies required to provide good enough assessment or care to the child. Second, there are a number of moral difficulties that rarely occur in the treatment of adults that are routine in the assessment and treatment of adolescents. For example, when treating adults, psychologists do not have to obtain permission of the parents to proceed or expect to have contact with the parents as treatment progresses. Adults entitled to a level of privacy in their treatment that minors do not enjoy. Law and custom have created a set of expectation and practices that limit the ability of minors to decide matters relating to their treatment. At the extreme, adults may deny that a teen has the capacity to consent to treatment or non-treatment, though teen may have ability to assent to them. The reason is that consent, especially once conjoined to the idea of being informed, requires that an informed consenter have had (a) an adequate comprehension of (b) what is conveyed about a proposed treatment, and that he (c) willingly and (d) without coercion (e) authorize treatment or reject it (Beauchamp & Childress, 2008). Adults and therapists are often skeptical of a teen's ability to meet these five conditions. When teens are sick, especially if their infirmity is grave and chronic, adults tend to gravitate to an even deeper skepticism about their decisional capacity. Furthering the tradition of skepticism about teens having what it takes to guide their own treatment is the economics of treatment. In the archetypical case, teens depend on their parents to pay for treatment. © 2009 Springer Science+Business Media, LLC.