The social institutions of medicine and the state have a complex history of interaction in which doctors have been the originators of political ideals, goals, and social change but equally often have found themselves to be instruments of political authority.
Preventing bad outcomes for teens and their offspring was the impetus behind confidential care for reproductive health. Requiring parental involvement created an obstacle to the provision of necessary care.
Parents want their child with severe disabilities to be accorded the same respect a healthy child gets, including a physical exam in the ER to diagnose and perhaps treat a minor illness unrelated to his or her impairments.
Physicians who have adequately informed a competent patient of his or her diagnosis, its meaning, and medically appropriate options should then accept the patient’s informed consent or refusal of treatment.