Adolescents ought to have the right to make autonomous medical choices.

Introduction Before I begin, I think prudence behooves an analysis of the resolution. The resolution states "Adolescents ought to have the right to make autonomous medical choices." This means that PRO in today"s debate must affirmatively persuade you, the judge, that as a matter of general principle, adolescents should be able to make medical decisions for themselves as a matter of right. CON, in contrast, must persuade you that as a matter of general principle, adolescents should not be able to make medical decisions for themselves as a matter of right. To affirm this resolution as a general principle, I need only argue that adolescents should have the right to make autonomous medical choices in some cases where they are capable. The resolution does not require the affirmation to argue that all adolescents should have a right to make all medical decisions only on their own. Rather, affirming this resolution requires only a denial of the status quo in which adolescents are generally presumed incompetent to make medical decisions on their own behalf. Insofar as this is an "opinion-topic" the burden of persuasion is equivalent on both sides, meaning that neither side has a greater or lesser persuasive burden than the other. The reason that the burden of persuasion is equivalent is because to do otherwise would be to show deference towards one side at the expense of the other, and therefore to undertake the exercise of judging this debate from a biased perspective. I think this was at one point an LD topic, or it might be an LD topic now. As such, while this debate necessarily entails certain value-based arguments, I"m not going to argue it as if it were an LD round such that I would begin by establishing a value and a criterion. As a roadmap, I"m going to begin by talking about the status quo of adolescents" right to autonomous medical choices, and then I"m going to present some arguments for why this probably isn"t the best way to go. The Status Quo of Adolescents" Right to Autonomous Medical Choices The law currently regards adolescents (people between the age of about 13-14 and 17) as generally incompetent to make medical decisions for themselves. What that means is that young people now do not have the right to decide what kind of medical care they receive or even if they receive it. That choice is left up to their parents or guardians, if they have parents or guardians, or to the state if the young people in question do not have parents or guardians. Adults, in contrast (people over the age of 18) get to make decisions for themselves because of the presumption that someone over the age of 18 is decisional capable of making those kinds of choices. Decisional capacity is a kind of hard concept to define, but to have decisional capacity is basically to have the ability to understand information, consider it carefully and make a decision on that basis. (1) It should come as no surprise that decisional capacity is not the exclusive province of adults. I think that as a general rule, if a kid can master the mysteries of calculus they can probably understand information relevant to their medical care -and an adult may not even be able to pass a high school calculus class. There is also some irony in the right to make autonomous medical decisions as it relates to adolescents in the sense that while a 16 or a 17 year old girl who gave birth could be legally required to make medical decisions that relates to the care of her child, that same 16 or 17 year old girl could not, in some jurisdictions, receive birth control from her doctor without parental consent. Alternatively, in almost all jurisdictions a fifteen year old boy could be charged as an adult for committing a crime like robbery or murder and punished as an adult on the premise that the boy had the mental acuity to appreciate the gravity of his decision to perform that crime, but the law might at the same time regard him incompetent to consent to or refuse certain medical care as a result of a sexually transmitted disease he could contract while incarcerated. That doesn"t make a whole lot of sense, does it? How can a teenager an adult (insofar as they are decisionally capable) when they commit crimes but a child (such that they are not decisionally capable) when it comes to medical care? Justice requires that adolescents have the right to make autonomous medical decisions. If justice requires that individual autonomy be respected, then to the extent that someone is capable of acting autonomously (in this case, being decisionally capable) that right ought to be respected. As a basic rule, if people can understand facts that are presented to them and they can make decisions on the basis of those facts, they should have a right to make choices for themselves about those facts. And the science here supports the notion that adolescents are decisionally capable; adolescents are, as a general rule, capable of understanding facts presented to them and making choices on the basis of those decisions. (1) A study from the late 1990s compared the decisions of four age groups (9, 14, 18 and 21 years) on outcome measures which were designed to measure the decisional capacity of those groups relative to the others. While the 9 year olds were less competent than the 21 year olds, there was no statistical difference between the decision making capacities of the 14, 18 and 21 year olds. (2) What that means is that the 14 year olds are generally as capable as the 18 and 21 year olds even though there was some statistically insignificant variation between them. So, that should be our standard for evaluating who gets the right to make autonomous medical decisions, and it"s fairly straightforward that adolescents can do that. That established, if someone is decisionally capable and that person is denied the right to make choices for themselves about matters that pertain to their wellbeing, then their right to autonomy is being violated. There are a lot of teenagers on this site, and they seem like they"re decisionally capable, so it seems proper that they should be afforded the right to make decisions that pertain to their medical care for themselves with or without the involvement of their parents. Sources 1. "Adolescent Autonomy: Clarifying an Ageless Conundrum" Hastings Law Journal 51 Hastings L.G. 1256. Rhonda Gay, J.D., Ph.D. August 2000. 2. "Involving Children and Adolescents in Medical Decision Making: Developmental and Clinical Considerations." Journal of Pediatric Psychology. Vol. 21.4: p. 507. Mary Ann McCabe, Department of Hematology/Oncology, Children"s National Medical Center. 1996.