Children, abortions, and informed consent

There is this large debate in the country over the question of whether we should allow school children to leave school during school hours to go get an abortion or receive treatment for STDs without the school being obligated or even permitted to inform the parents.

This is a rather odd debate. Why the children cannot go to these free clinics or Planned Parenthood after school is beyond me. Why does this have to be done on school time? Is this a new way to get out of school?

But independent of that, there is a really important issue at stake.

After the various atrocities of the Nazis during WWII were revealed the field of medical ethics arose. That is, after we saw the sorts of experiments that went on in places like Dachau where Jews and other prisoners were used as part of medical experiments, the medical and academic communities took note. Prisoners were the subject of drowning, disease, and pressure experiments that amounted to little more than torture and death for most of them.

What emerged from this was a concept that was to become the cornerstone of medical ethics: informed consent. One can only perform a procedure on a patient when and only when there was informed consent given for that procedure. That means that if there was no consent, or it was not a consent that was given by someone who was able to give consent in an informed way, then there is a major breach of accepted medical ethics.

There are some classes of people who are incapable of giving informed consent. Individuals who are very mentally handicapped are generally taken to be unable to give informed consent. Children too are unable to do this. That is why one is not allowed to have sex with minors, or sell or give liquor to minors. They cannot vote or smoke. We say this because they cannot give informed consent for these sorts of things because they are judged not to have the maturity to make certain decisions.

Parents are charged with these responsibilities. Parents can make the decisions for the children. Parents must make the decision for the students. Parents are taken to have the best interest of the children and thus the capability and the right to make the decision for the children.

Now there are certain criterion where we do want to allow the children to make the decision for themselves. This happens when we believe the child to have the maturity and intellectual maturity to make an informed decision. But if this is the case we should also give the children the responsibilities of an adult. For example, we often refer to emancipated minors who are not accountable to their parents. We sometimes try children as adults in courts of law. We ought to make those analogies. In a case where we can say that had the child committed some crime, we would have tried him or her as an adult, then we can say that we should allow the child to make medical decisions. Of course the responsibility is also on the doctors who perform these procedures that they are performing them on people who can make informed decisions.

If we just allow children the "right" to leave school and make decisions that they are incapable of making correctly we have thrown away 50 years of progress in medical ethics.