G360 Minority report: can minor-parents refuse medical treatment for their child

Infants are unable to make their own decisions or express their own wishes about medical procedures and treatments. They rely upon surrogates to make decisions for them. Who should be the decision-maker when an infant’s biological parents are also minors? M, is a 15 year old girl who has a long-standing needle phobia, she gives birth to B and is assessed to be capable of caring for him. B is discharged into M’s care on the second day of life. However, on day 7 the baby develops apnoeas and is brought to hospital by M and her own mother, G, with whom they live. There are signs that B has sepsis. The paediatricians plan to insert an intravenous cannula (IV) and perform a lumbar puncture (LP) to exclude meningitis. M consents to an IV for B and administration of antibiotics. However, she finds the process so distressing she refuses consent for B to undergo the LP. The central questions raised by the case are whether minor-parents should make medical decisions on behalf of an infant, and if so, what are the limits to this decision-making authority? In particular, can they refuse treatment that might be considered best for the infant? We examine different claims to parental decision-making authority; we argue that provided that minor-parents are capable of fulfilling their parental duties, they should have a right to make medical decisions for their infant. We then examine the limits to minor parents’ decision-making authority for their children. We argue that the restricted authority that teenagers are granted to make medical decisions for themselves looks very similar to the restricted autonomy of all parents. That is, they are permitted to make choices, but not harmful choices. Like all parents, minor parents must not abuse or neglect their children and must also promote their welfare. They have a right to make medical decisions for their infants within the same ‘zone of parental discretion’ that applies to adult parents. We conclude that adult and adolescent parents should have comparable decision-making authority for their infants.