Friday, February 6

You make the call...17 year old mother...

Many protocols are similar when it comes to when a person can or can not refuse medical care. It often includes such situations as Active Duty military, emancipated minor or the like, but what about when that person is responsible for another little person?

I'm called to an MVA and find a family from the local Air Force Base lost control on the ice and crashed into a parked car. There are minor injuries to the driver, who is in his early twenties, and is refusing treatment, which we agree is appropriate. The female is 17 and is experiencing lower abdominal pain where the seat belt was. Not entirely uncommon, but we advise that, because of her young age, there may be something the doctors can make sure doesn't become a problem in the future. She is refusing care as well. She is not married to the gentleman in the car, nor is he the father of the child.
The 6 month old, properly secured to her car seat, is smiling and doesn't appear to have even noticed the car is stopped.

My question to all of you, keeping in mind protocols vary by jurisdiction, is this:
Based on your local protocols can the 17 year old unwed mother make her own medical decisions and refuse treatment?

If your answer is no, as the biological mother of the minor child, can she make medical decisions for that child?

You make the call.


Anonymous said...

That 17 yo became emancipated when she got pregnant and is responsible for her medical and that of her child.

Anonymous said...

Interesting but fairly straightorward over here. At 17yrs old the patient can make decisions on her own wellbeing and until the child is born, the mother always remains the priority. With the introduction of the Mental Capacity Act last year in the Uk, if a patient can show they have "capacity" to make their own decisionsthen we can not go against them even if we really want to.
If I was handling this one, I would ultimately leave the mother at the scene after trying numerous times to persuade her to go to hospital. I would document, document, document everything I said to her and my multiple attempts to get her to go to hospital then I would get her to sign the "respond not conveyed" form stating that she is going against my advice and has the capacity to do so. Wether or not I follow it up with a "vulnerable child form" to social services would be a decision I would make depending on my concerns at the scene.
What did you do?

Anonymous said...

Sorry about spelling mistakes and punctuation errors in the comment above. iPhone and moving vehicles sometimes don't go too well together.

Anonymous said...

It may be different elsewhere, but in CT the mother can make decisions for the child, but not for herself. For example, since she is under 18 and considered a minor (for argument's sake she is not emancipated and you cannot contact a parent/guardian, etc) by law she would be treated and transported under implied consent. However, since she is the mother of the child, she may make any and all decisions for the child, even though she herself is a minor.

Chris said...

As 999 says, the mother has capacity to decide for herself, and therefore for the baby. Personally, I don't like the concept that any parent could refuse medical care on behalf of their child - whilst many are capable of making the right decision on behalf of their child, there is a large minority of people who will base decisions about what is best for their child on sensationalist media misrepresentation (eg. MMR vaccine) or their own religion - not necessarily that of the child who may not yet have the ability to decide on their own religious viewpoint - (eg. blood transfusions)

To my mind, decisions regarding the treatment of minors should be left to the professionals, with input from the parents in cases such as terminal illness