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Ethics and adolescent care: an international perspective

Michaud, Pierre-Andréa; Berg-Kelly, Kristinab; Macfarlane, Aidanc; Benaroyo, Lazarea

doi: 10.1097/MOP.0b013e32833b53ec
Adolescent medicine: Edited by Sara F. Forman and Elizabeth R. Woods

Purpose of review: This update reviews the concepts underlying ethical issues in various contexts and countries, highlighting the evolution in the use of the core values underpinning the field and practice of bioethics as applied to healthcare.

Recent findings: It stresses the specific position of the adolescent as being a unique individual searching for autonomy and, most of the time, being competent to make decisions regarding the adolescent's own health. It briefly outlines the principles of a ‘deliberative’ approach in which the practitioner, while keeping in mind the legal context of the country where the practitioner is working, assesses to what extent the adolescent can be considered as competent, and then discusses with the adolescent the medical and psychosocial aspects of the various actions to be taken in a situation, as well as the basic ethical values linked with each of the various options available. The deliberation can involve relevant stakeholders, provided the issues concerning confidentiality have been fully discussed with the adolescent.

Summary: This process forces the practitioner, the adolescent patient and those who care for the adolescent patient to look outside their usual frameworks and make a decision that is in the best interest of the young person, and is informed by various ethical values.

aCentre hospitalier universitaire vaudois, Lausanne, Switzerland

bLinné Gatan 33, Göteborg, Sweden

cIndependent International Consulting in Strategic Planning Child and Adolescent Health Services, 6 Cobden Crescent, Oxford, UK

Correspondence to Professor Pierre-André Michaud, MD, UMSA, CHUV, 1011 Lausanne, Switzerland Tel: +41 21 314 37 60; fax: +41 21 314 37 69; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.