Can Children Make Medical Decisions?
by kabrina_peron on September 12, 2016 - 5:40pm
Makayla Sault is an 11 year old Ontario Aboriginal girl who was diagnosed with lymphoblastic leukemia. She was given a 75 per cent chance of survival as she started chemotherapy at McMaster's Children's Hospital in Hamilton (Walker). However, due to the intensive treatments, she experienced severe side-effects. One day, she had a vision of Jesus at the hospital and, shortly after, she wrote a letter to the medical team saying that she would no longer pursue her treatments. After 12 weeks of chemotherapy, Makayla and her family opted for traditional indigenous medicine. Unfortunately, Makayla passed away in early January 2015. The young girl's death raised questions whether children should be allowed to make their own medical decisions. As a result, people are divided over this debate on children controlling their medical treatments. For this particular debate, only children of grade-school age up until 18 years are concerned.
The first side of the debate covers people in favour of children making their own medical decisions. A value behind this view would be autonomy since children are aware enough of their condition to make their own medical decisions without any interference. With that said, people, including doctors, should respect others' autonomy. A child being able to recognize the gravity of their condition demonstrates a certain maturity. Moreover, for Makayla, tradition represents an important value since it is what persuaded her towards indigenous traditional medicine. In Ontario, the law says that everyone under twelve years of age can make their own health decisions (Alamenciak). Also, age is irrelevant when considering if an individual can understand a medical decision (Alamenciak). Sick children are the ones who suffer great pain. Makayla quoted: ''I am writing this letter to tell you that this chemo is killing my body and I cannot take it anymore'' (Alamenciak). As a result, everybody's interests should have equal consideration meaning that the child's opinion should weight in a decision since he is the one who will be mainly affected. Also, the child will follow the ethical guideline of acting for the greater good because he will not make a choice to make him worse off. In this case, the greater good of any child would be eliminating their pain which Makayla did by backing out of chemotherapy.
The second side of the debate represents the ones against children making their own medical decisions. A value behind this view would be security, meaning securing the child's health by giving all possible treatments in order to put all chances of survival on his side. In addition, by letting decision-making out of a child's hands, there is a value of parental responsibility since they are the ones who officialise decisions until the age of 18, in Quebec at least. Arthur Schafer, director of the University of Manitoba for Professional and Applied Ethics says that he could understand why a child might not want chemotherapy, but would not truly understand the implications of abandoning the treatment (Alamenciak). For example, Makayla chose to stop chemotherapy and pursue her life, but she probably did not imagine that it would end up by killing her. According to the Canadian Pediatric Society, children of primary school age do not have the full capacity to make their own health-related decisions (Alamenciak). Children do not have the same experiences and life baggage as their parents and doctors. As an ethical principle states, human life is fundamentally valuable. A child does not yet know the value and beauty of life.
In conclusion, in my opinion, children should not be able to make their own medical decision because they have not yet developed the full capacity of decision-making without considering all possible outcomes. Parents should take full responsibility for their children and make the decisions for them since they do not have the maturity to make these type of choices. For example, at a young age, children are impatient and want to immediately eliminate pain, but do not evaluate the outcome whereas, as an adult, people generally tolerate pain better. Furthermore, as an individual grows up, they realize that life is a gift and, unfortunately some do not benefit from it as long as they would wish. At 11 years of age, a child does not have a big enough framework of life experiences to be able to make a decision that he could potentially die from. For Makayla, when she made the decision, she did not know what she was giving up. Thus, when a child like Makayla dies, should parents be blamed since they did not come forward enough about their child's medical decisions?
Alamenciak, Tim. ''Ontario Law Allows Children To Determine Medical Care''. TheStar.com, 20 Jan. 2015, https://www.thestar.com/news/gta/2015/01/20/ontario-law-allows-children-... . Accessed 2 Sept. 2016.
Guichon, Juliet., et al. ''Makayla Too Young To Make Medical Decision.'' The Hamilton Spectator, 31 May 2014, http://www.thespec.com/opinion-story/4550627-makayla-too-young-to-make-m... . Accessed 6 Sept. 2016.
Walker, Connie. ''Makayla Sault, girl who refused chemo for leukemia, dies.'' CBC News, 19 Jan. 2015, http://www.cbc.ca/news/aboriginal/makayla-sault-girl-who-refused-chemo-f... . Accessed 2 Sept. 2016.