Ethical challenges in the emergency care of adolescent patients

E MERGENCY PHYSICIANS face ethical challenges when working with adoleseents. With young children, parents play a eentral role in medieal deeision-making. Even in emergency situations, physicians seek parental consen t pr ior to t rea tment , when parents are available. Parental roles beeo me more eompl iea ted with the adoleseent patient, who is often eapable of part ieipat ing meaningfully in medical decis ion-making long before he or she is eonsidered an adult. Most states now recognize a l imited right for minors not only to par t ie ipate in medical deeision-making, but to make cer tain t r ea tmen t decisions independent of parenta l wishes. The recognit ion of such rights ehallenges the tradit ional role of parents , some of whom believe tha t they should retain sole deeis ion-making authori ty. Challenging quest ions emerge for the emergeney physie ian earing for the adoleseent: When should minors be pe rmi t t ed to make t r ea tmen t deeisions? How should physic ians respond to conflicts be tween parents and adolescents? When minors possess the capaci ty necessary to make t r ea tmen t decisions, do parents and physicians have an obligation to respeet their wishes?