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September 1997

In Their Own Hands: Adolescents' Refusals of Medical Treatment

Author Affiliations

From Stanford Law School, Stanford, Calif (Mss Traugott and Alpers); and the Program in Medical Ethics, the Center for AIDS Prevention Studies, and the Division of General Internal Medicine, University of California, San Francisco (Ms Alpers).

Arch Pediatr Adolesc Med. 1997;151(9):922-927. doi:10.1001/archpedi.1997.02170460060010

In 1994, 3 adolescents between the ages of 15 and 16 years who had cancer or liver failure refused life-prolonging medical therapy that had serious adverse effects and required long-term administration. These refusals created ethical dilemmas for the adolescents' physicians, whose duty to act in the best interests of their patients conflicted with the choices of the adolescents and sometimes their parents.

Editor's Note: This thought-provoking and illuminating discussion of 3 well-publicized cases of adolescents who refused life-prolonging treatment should stimulate us all to think about this important issue. Ethics rounds, anyone?

Catherine D. DeAngelis, MD

Adolescents whose refusals of therapy are not seriously considered by their parents or physicians may take drastic steps to avoid treatment. Conflict between physicians and families that leads to litigation may destroy the physician-patient relationship. Two of the adolescents ran away from home and 1 case resulted in the alienation of an entire community