My God My Choice: The Mature Minor Doctrine and Adolescent Refusal of Life-Saving or Sustaining Medical Treatment Based Upon Religious Beliefs

Abstract

Adults, those over the age of eighteen, are presumed competent and therefore enjoy a certain level of autonomous decision-making free from outside intrusion. Those who have not reached the age of majority, on the other hand, are presumed incompetent, and thus require the aid of parents or guardians to assist in the decision-making process. Recent studies in adolescent development suggest that certain individuals, though not yet eighteen, have the requisite competence to make informed, autonomous medical decisions. In turn, some states have acknowledged the mature minor doctrine, which is based on the seemingly simple principle that minors who demonstrate a sufficient level of maturity ought to have their choices respected independent of third parties.

Though many agree that certain adolescents reason on a level equal to that of young adults, debate surrounds the conclusion that minors should be permitted to consent to or refuse medical treatment especially when the choice has life or death consequences. A further complication exists when the decision is based upon religious beliefs.

To date, the relevant literature focuses on parents' religious beliefs that influence medical decision making for their minor children, and minors' maturity to decide medical care for themselves. Although some courts and scholars have addressed these topics in the same document, little attention has been paid to the unique circumstances involved when adolescents attempt to refuse life-saving or sustaining medical treatment based upon their expressed religious beliefs. Failing to address the religious maturity of the minors in question creates the possibility that they will be permitted to die for beliefs that are not truly their own.

The thesis of this paper is that under these circumstances practitioners ought to inquire into the maturity of the religious beliefs of the adolescents. Because the religious upbringing of children is directed by the beliefs of their parents and ministers, it is necessary to ensure that the adolescents have developed their own underlying and enduring aims and values. Thus, these adolescents should have the burden to demonstrate clearly and convincingly that they understand their beliefs, as well as the consequences of the medical decision. Only then can practitioners be comfortable that the minors, independent of third party influence or coercion, have the ability to make an autonomous decision to die for those beliefs in line with their true sense of well-being.

Keywords: Law, Bioethics, Mature Minor, Religion, Medical Decision Making, Conscientious Objection