Adolescents in Health Care Systems

Abstract

Adolescents’ rights in health care systems complicate the challenging issues that typically characterize adolescents’ rights. This chapter addresses the complexities that come with the provision of health care to adolescents, especially as they relate to considerations of broader public health, professionals’ code of ethics, and families’ roles in the provision of care. Three issues arise when considering adolescents’ ability to control or otherwise have a voice in their medical care: their level of competence, confidentiality, and informed consent. Legally, these issues translate into concerns about the Fourteenth Amendment’s guarantee against the significant deprivation of liberty without due process of law. The health care context describes some aspects of that liberty, particularly the right to access care and the right to refuse care. In doing so, the cases highlight the important distinction between substantive due process (the nature of the relevant liberty, such as the “right to privacy”) and procedural due process (the mechanisms in place to protect the substantive liberty, such as a right to judicial hearings when the interests of parents and their children potentially conflict). Both aspects are critical to consider, as procedural protections increase in robustness as the relevant substantive liberty’s importance increases. Despite that general rule, this area of law tends to frame adolescents’ rights as the type that parents control. In doing so, this area of law does not recognize rights that governments must provide, as there is no general right to health care provided affirmatively at the government’s expense.