Abstract
Minors' capacities to provide a valid informed consent for the treatment of medical and psychological disorders are contingent in part on the determination of whether they can make voluntary treatment decisions. The gravity of a medical dilemma and the nature of parental influence are two factors hypothesized to effect and perhaps compromise the voluntariness of treatment decisions made by adolescents. In the present study 40 14- and 15-year-old subjects were asked to note their conviction for treatment decisions they had made in response to hypothetical medical dilemmas in which parental influence varied. It was found that adolescents making treatment decisions are generally deferent to parental influence, although they are more likely to resist parental influence when the consequences of the decision have serious implications for the hypothetical adolescent's health.
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Abram, H. S., & Buchanan, D. C. (1976). The gift of life: A review of the psychological aspects of kidney transplants.International Journal of Psychiatry in Medicine, 7, 153–164.
Akio Kuwahara v. Acheson, 97 F. Supp. 38, 42 (D.C. Cal. 1951).
Bateson, G. (1979).Mind and nature: A necessary unity. New York: Dutton.
Baumrind, D. (1978). Reciprocal rights and responsibilities in parent-child relations.Journal of Social Issues, 34, 179–195.
Bell, R. Q., & Harper, L. V. (1977).Child effects on adults. Hillsdale, New Jersey: Lawrence Erlbaum Assoc.
Berndt, T. J. (1979). Developmental changes in conformity to peers and parents.Developmental Psychology, 15, 608–616.
Bersoff, D. N., & Ogden, D. W. (1987).In the Supreme Court of the United States: Hartigan v. Zbaraz and Charles. Brief for Amicus Curiae, American Psychological Association in support of eppellees. Washington, D.C.: Wilson-Epes.
Bishop, B. R., & Beckman, L. (1971). Developmental conformity.Developmental Psychology, 5, 536.
Brehm, S. S. (1977). The effect of adult influence on children's preferences: Compliance versus opposition.Journal of Abnormal Child Psychology, 5, 31–41.
Brehm, S. S., & Brehm, J. W. (1981).Psychological reactance. New York: Academic Press.
Colorado v. Connelly, 55 U.S.L.W. 4043, (1986).
Constanzo, P. R., & Shaw, M. E. (1966). Conformity as a function of age level.Child Development, 37, 967–975.
Culver, C. M. (1982).Philosophy in medicine, New York: Oxford University Press.
Deci, E. L. (1980).The psychology of self-determination. Lexington, Massachusetts: Lexington Books.
deTurck, M. A., & Miller, G. R. (1983). Adolescent perceptions of parental persuasive message strategies.Journal of Marriage and the Family, 45, 543–551.
Ehrenreich, N. S., & Melton, G. B. (1983). Ethical and legal issues in the treatment of children. In C. E. Walker & M. C. Roberts (Eds.),Handbook of clinical child psychology (pp. 1285–1305). New York: Wiley.
Eisendrath, R. M., Guttmann, R. D., & Murray, J. E. (1969). Psychological considerations in the selection of kidney transplant donors.Surgery, Gynecology, and Obstetrics, 129, 243–248.
Fost, N. (1977). Children as renal donors.New England Journal of Medicine, 196, 363–367.
Grisso, T., & Vierling, L. (1978). Minors' consent to treatment: A developmental perspective.Professional Psychology, 9, 412–427.
Grodin, M. A., & Alpert, J. J. (1983). Informed consent and pediatric care. In G. B. Melton, G. P. Koocher, & M. J. Saks (Eds.),Children's competence to consent (pp. 93–110). New York: Plenum Press.
Haley v. Ohio, 332 U.S. 596 (1948).
Harris, R. J. (1975).A primer of multivariate statistics. New York: Academic Press.
Howard, G. S., & Conway, C. G. (1986). Can there be an empirical science of volitional action?American Psychologist, 41, 1241–1251.
In re Gault, 387 U.S. 1, 13 (1967).
In re Green, 448 Pa. 338, 292 A.2d 387 (1972).
James, W. (1890/1950).The principles of psychology: Vol. II. New York: Dover.
Keith-Spiegel, P. (1983). Children and consent to participate in research. In G. B. Melton, G. P. Koocher, & M. J. Saks (Eds.),Children's competence to consent (pp. 179–211). New York: Plenum Press.
Kemph, J. P., Bermann, E. A., & Coppolillo, H. P. (1969). Kidney transplants and shifts in family dynamics.American Journal of Psychiatry, 125, 1485–1490.
Kohlberg, L. (1964). The development of moral character and moral ideology. In M. Hoffman & L. Hoffman (Eds.),Review of child development research, Vol 1 (pp. 383–431). New York: Sage Publications.
Koocher, G. P. (Ed.) (1976).Children's rights and the mental health professions. New York: Wiley.
Lewin, K. (1951). Intention, will, and need. In D. Rappaport (Ed.),Organization and pathology of thought (pp. 95–150). New York: Columbia University Press.
Lewis, C. C. (1981). How adolescents approach decisions: Changes over grades seven to twelve and policy implications.Child Development, 52, 538–544.
Marks, F. R. (1975). Detours on the road to maturity: A view of the legal conception of growing up and letting go.Law and Contemporary Problems, 39, 78–92.
McKinnon v. Parrill, Ill Ind. Apr. 343, 38 N.E. 2d 1008, 1014 (1942).
Meisel, A., Roth, L. H., & Lidz, C. W. (1977). Toward a model of the legal doctrine of informed consent.American Journal of Psychiatry, 134, 285–289.
Melton, G. B. (1983a).Child advocacy: Psychological issues and interventions. New York: Plenum Press.
Melton, G. B. (1983b). Children's competence to consent: A problem in law and social science. In G. B. Melton, G. P. Koocher, & M. J. Saks (Eds.),Children's competence to consent (pp 1–21), New York: Plenum Press.
Melton, G. B. (1983c). Decision making by children: Psychological risks and benefits. In G. B. Melton, G. P. Koocher, & M. J. Saks (Eds.),Children's competence to consent (pp. 21–40), New York: Plenum Press.
Melton, G. B. (1983d). Toward “personhood” for adolescents.American Psychologist, 38, 99–103.
Melton, G. B., Koocher, G. P., & Saks, M. J. (Eds.) (1983).Children's competence to consent. New York: Plenum Press.
Milgram, S. (1974).Obedience to authority. New York: Harper & Row.
Mnookin, R. H. (1978). Children's rights: Beyond kiddie libbers and child savers.Journal of Clinical Child Psychology, 7, 163–167.
Morrison, D. F. (1967).Multivariate statistical methods. New York: McGraw-Hill.
Mulvey, E. P., Reppucci, N. D., & Weithorn, L. A. (1984). Mental health, law, and children: A brief overview. In N. D. Reppucci, L. A. Weithorn, E. P. Mulvey, & J. Monahan (Eds.),Children, mental health and the law (pp. 15–24). Beverly Hills: Sage Publications.
Murphy, J. G. (1979). Therapy and the problem of autonomous consent.International Journal of Law and Psychiatry, 2, 415–430.
Nichols, M. P. (1984).Family therapy: Concepts and methods. New York: Gardner Press.
O'Brien, R. G., & Kaiser, M. K. (1985). MANOVA method for analyzing repeated measures designs: An extensive primer.Psychological Bulletin, 97, 316–333.
Patel, S. D., & Gordon, J. E. (1960). Some personal and situational determinants of yielding to influence.Journal of Abnormal and Social Psychology, 61, 411–418.
Piaget, J. (1967). Six psychological studies. New York: Random House.
Rogers, C. M., & Wrightsman, L. S. (1978). Attitudes toward children's rights: Nurturance or self-determination?Journal of Social Issues, 34, 59–67.
Rollins, B. C., & Thomas, D. L. (1975). A theory of parental power and child compliance. In R. E. Cromwell & D. H. Olsen (Eds.),Power in families (pp. 38–60). Beverly Hills: Sage Publications.
Saks, M. J. (1978). Social psychological contributions to a legislative subcommittee on organ and tissue transplants.American Psychologist, 33, 680–690.
Saks, M. J. (1983). Social psychological perspectives on the problem of consent. In G. B. Melton, G. P. Koocher, & M. J. Saks (Eds.),Children's competence to consent (pp. 41–53). New York: Plenum Press.
Selvini, M. P., Boscolo, L., Cecchin, G., & Prata, G. (1980). Hypothesizing-circularity-neutrality: Three guidelines for the conduct of the session.Family Process, 19, 2–12.
Skolnick, A. (1975). The limits of childhood: Conceptions of child development and social context.Law and Contemporary Problems, 39, 38–77.
Smith, T. E. (1970). Foundations of parental influence upon adolescents: An application of social power theory.American Sociological Review, 35, 860–872.
Smith, T. E. (1983). Adolescent reactions to attempted parental control and influence techniques.Journal of Marriage and the Family, 45, 533–542.
State v. Thomas, 250 Mo. 189, 157 S. W. 330, 338 (1913).
Stricker, L. J., Messick, S., & Jackson, D. N. (1970). Conformity, anti-conformity, and independence? Their dimensionality and generality.Journal of Personality and Social Psychology, 16, 494–507.
Sullivan, E. V., McCullough, C., & Stager, M. (1971). A developmental study of the relationship between conceptual, ego, and moral development.Child Development, 41, 399–411.
Tedeschi, J. T., & Lindskold, S. (1976).Social psychology: Interdependence, interaction, and influence. New York: Wiley.
Tinker v. Des Moines Independent School District, 393 U.S. 503 (1963).
Wadlington, W. J. (1983). Consent to medical care for minor's: The legal framework. In G. B. Melton, G. P. Koocher, & M. J. Saks (Eds.),Children's competence to consent (pp. 57–74). New York: Plenum Press.
Waltz, J., & Scheuneman, T. (1970). Informed consent to therapy.Northwestern University Law School, 64, 628–650.
Weithorn, L. A. (in progress). Competency to consent to psychiatric treatment.
Weithorn, L. A., & Campbell, S. B. (1982). The competency of children and adolescents to make informed treatment decisions.Child Development, 53, 1589–1598.
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This investigation was supported in part by a grant from the American Psychology-Law Society/ Division 41 of the American Psychological Association, whose assistance is gratefully acknowledged. Gratitude is also extended to the Albemarle County School District, the Blue Ridge School. and St. Anne's-Belfield for their kind cooperation. The authors wish to thank William Gardner, Jeanne Smith, and Edith Lawrence for their work on behalf of this project. Special recognition is due to Lois A. Weithorn for her guidance and support of this research endeavor.
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Scherer, D.G., Reppucci, N.D. Adolescents' capacities to provide voluntary informed consent. Law Hum Behav 12, 123–141 (1988). https://doi.org/10.1007/BF01073121
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DOI: https://doi.org/10.1007/BF01073121