Adolescents' Right to Refuse Treatment Hinges on State Laws. (Consult Counsel)

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NEW YORK -- An adolescent's right to refuse treatment is not just a matter of age and competence.

The risks and benefits of the specific intervention involved, and the laws of the particular jurisdiction also must be taken into account, Dr. Richard Rosner said at the annual meeting of the American Society for Adolescent Psychiatry.

Because of their complexity, these and other forensic issues are often best addressed in consultation with counsel from one's malpractice carrier, suggested Dr. Rosner, medical director of the Forensic Psychiatry Clinic, Bellevue Hospital, New York.

As with patients generally, the decision to refuse treatment must be made freely, by a competent individual, based on adequate information.

Choosing freely means that the adolescent understands his or her rights and is not subject to subtle or blatant forms of coercion. Competence 'may require a demonstrated grasp of the risks and benefits of refusing treatment. In some jurisdictions, and for some treatments, the adolescent must be able to cite a reason for refusal, which may need to be "rational."

Whether the adolescent has the right to refuse treatment depends on the particular treatment and varies from state to state. If the risks of a treatment are great and the benefits are few, competence criteria are likely to be relatively lax. …


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