Paula Tironi, JD, LLM and Monique M. Karaganis, MD
While parents often have legal authority to make decisions regarding pediatric palliative care, federal and state statutory and case laws, like CAPTA, impose significant restrictions on that authority.
Advance directives do not always resolve questions about the best care for patients who no longer have decision-making capacity; physicians and patient surrogates can take alternative approaches to arrive at the best care decision.
Clinical and psychosocial considerations influence how oncologists approach discussing sperm banking with adolescent patients who are about to undergo chemotherapy and with the parents of those patients.
Physicians treating adolescents need to give them the information to make intelligent and responsible decisions regarding sexual activity and reassure them of patient confidentiality.
Psychiatrists face difficulties when deciding on treatment plans for patients who are not interested in receiving help or are lacking the capacity to make responsible decisions.