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?

Works Cited

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.

Comments

The topic that you chose is very interesting to read! Your arguments on both sides are well-presented. It is true that children do not have the full capacity to think with all the consequences that can be after making the choice. However, I believe that they still have the right to choose what they want to do. They want to be true to themselves by following their heart, just like some patients who decide to end their lives since they could not support anymore. We are not them, so we cannot make decisions for them by assumptions. I do not think that we should blame the parents since all they did was only to respect their daughter's choice. I believe that it is very hard for them to make this decision since none of the parents want to see their daughter die in front of them. Why are we taking other's right to choose for themselves? Everyone is equal, no matter how old he/she is.

This was great topic that you picked and a controversial one too. I also like you're style of writing and the way you structure your text, having a proper intro, body and conclusion. Both sides of the topic are brought up equally.

As for your topic, I understand that young children might not have the capacity to understand the gravity of the situation, or how to properly understand what's going on. I agree with you that some children do not have the capacity to make their own decisions; however, a child must still be given a degree of freedom. A person's body is theirs, and there comes a point where no one can tell them how to handle it. Although they might make a fatal decision that can lead to their deaths, and doctors are obligated to help to a certain extent, I ultimately believe that people should be able to make decisions for themselves. Freedom is an important feature for humans, and our autonomy is important. There does need to be a limit in place however, that much I agree on. Young children, especially fewer than 12 have little capacity to understand what's going on, and therefore it is up to the parents to guide their children and make these decisions for them though.

It leads to the questions however, at when should a child be able to decide their own medical decisions for themselves?

You wrote a very interesting post. Your arguments and values are very well explained. I agree that children can not make medical decisions because they don't fully understand the weight of his/her own condition. I know people can argue that children have their own rights to make decisions for themselves, but they don't really understand the importance of his own life when they are that young. That's why, they only want to eliminate pain without knowing that their life will end sooner or later. Without much experiences in life, their critical thinking is not well developed. Children do not know what consequences their decisions might lead them into. Religious aspects can also be considered in this issue: God created life and he is the only one that could end it. Life is given to them, so they should cherish it, not abandon it. With 75% of chance survival, Makayla should be able to feel better at the end if she could endure the pain at that moment. This is not really a matter of equal rights between parents and children. What really matters is to not give up on whatever can sustain life. Will enduring pain benefits a person's future?

Your post was very well written and organized. It showed that you had thoroughly done your research and you had very detailed explanations. The use of Makayla Sault’s was very impactful and gave readers direct insight on how she felt.

I agree with your second argument and your personal opinion that children cannot fully understand and make their own medical decisions. The fundamental role of a parent is to guide their children to make good decisions and make the choice for them when they are not capable. Parental responsibility is definitely a value you can relate to your argument against young children making their own medical decisions. Children simply do not have enough knowledge to grasp entirely the situation.

In this case, could have Mikayla’s cultural beliefs have impacted her decision to refuse chemotherapy more than her ability to understand her medical decisions?