Academic journal article Journal of Law and Health

Do Not Resuscitate Decision-Making: Ohio's Do Not Resuscitate Law Should Be Amended to Include a Mature Minor's Right to Initiate a DNR Order

Academic journal article Journal of Law and Health

Do Not Resuscitate Decision-Making: Ohio's Do Not Resuscitate Law Should Be Amended to Include a Mature Minor's Right to Initiate a DNR Order

Article excerpt

 
   I. INTRODUCTION 
  II. DO NOT RESUSCITATE: AN OVERVIEW 
      A. A Do Not Resuscitate Order: What is it and 
         Why is it Issued? 
      B. Ohio's Current Do Not Resuscitate Law 
 III. A LOOK AT THE MINOR AND HEALTHCARE: PAST AND 
      PRESENT 
      A. A Historical Glance at the Minor's Healthcare 
         Rights 
      B. Exceptions to the Common Law Rule 
      C. Ohio's Statutory Exceptions 
  IV. THE EVOLUTION OF THE MATURE MINOR EXCEPTION 
      A. The Mature Minor Exception Defined 
      B. Cases Involving a Mature Minor's Right to 
         Consent or Refuse Medical Treatment 
      C. The Medical Perspective 
   V. NEW YORK AND WEST VIRGINIA: RECOGNITION OF 
      A MATURE MINORVS RIGHTS IN DO NOT RESUSCITATE 
      LAW 
      A. West Virginia's DNR Law 
      B. New York's DNR Law 
  VI. THE MATURE MINOR DOCTRINE AS APPLIED TO 
      THE ABORTION DECISION 
      A. Ohio's Abortion Law 
      B. Court Decisions on the Mature Minor's Right to 
         Consent to an Abortion 
 VII. PROPOSED AMENDMENT TO OHIO'S DO NOT 
      RESUSCITATE LAW 
VIII. CONCLUSION 

I. INTRODUCTION

"Constitutional rights do not mature and come into being magically only when one attains the state-defined age of majority. Minors, as well as adults, are protected by the Constitution and possess Constitutional rights." (1)

Consider the following scenario in light of the ethical and the legal implications that would arise:

 
   A cystic fibrosis patient, nearly 18 years old and unmarried, is 
   brought to the ER in respiratory distress. She's told the ER 
   nurses and the attending doctor that she wants a Do Not Resuscitate 
   (DNR) order, but her parents are refusing to sign it. Meanwhile, the 
   patient goes into respiratory arrest. 
   What would you do? (2) 

This scenario was printed in a 1993 edition of the nursing magazine, RN, along with the responses provided from various nursing professionals. In reply, the majority of nurses expressed that any solution would be problematic based on the ethical and legal issues involved. (3) For instance, a Tennessee home health nurse wrote "I would have to assist in the code [to resuscitate], even though it would break my heart," (4) and a Pennsylvania rehab nurse commented "I would like to honor the patient's wishes, but I have no legal basis for doing so." (5) The moderator, Amy Haddad, a physician and widely publicized ethicist, noted that although parents have the legal right to make medical decisions for their minor children, minors have rights as well. (6) Even if there are ethical reasons for not issuing or implementing a DNR, we must remember that parents do not always do what is best for their children, and it is possible that there are other factors that must be taken into consideration. (7)

As reflected by the scenario, as well as the nurses' responses, matters involving a minor's capacity to make health care decisions are highly debated. Changes in both the common law and legislation over the years have resulted in minors gaining some degree of autonomy in making their own medical decisions. (8) According to Professor Angela Holder, "[t]he court and legislatures of this country have not been unmindful of [these] societal changes, and there is a definite trend toward allowing adolescents more freedom to make decisions, and to exercise autonomy and self-determination in their relationships with healthcare providers." (9) Even though these decisions typically involve low-risk medical procedures, as opposed to life-saving or life-sustaining treatment, some states permit minors to make significant medical decisions, including whether to have an abortion without parental consent or notice. (10) Using reasoning similar to the abortion argument, this note will conclude that Ohio's DNR Order law should be amended to include an exception for unemancipated mature minors who wish to initiate a DNR order when their parents refuse to consent on their behalf. …

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