The Integrated Behavioural and Biological Sentinel Surveys, the National HIV/AIDS Reproductive Health Surveys and the National Demographic Health Surveys engaged participants 15 years of age.51 The studies capture issues relevant to sexual and reproductive health. endobj The implication for adolescents resident with surrogate caregivers is exclusion from research which could be of benefit both to the participants and the broader population. Chassin, L., C.C. Adolescents and Informed Consent: Ethical and Legal Issues : The - LWW Moskop JC, Marco CA, Larkin GL, Geiderman JM, Derse AR. In many communities, young people have surrogate caregivers who are not formally appointed as legal guardians. This points to the need to design and implement research that addresses the needs of adolescents including STDs and HIV, adverse pregnancy outcomes, violence and mental health. In general, relying upon principles of shared decision-making (SDM), providers must strive to provide comprehensive, accessible care for adolescents that is respectful of their evolving autonomy and emerging capacity, while supporting and facilitating open and honest communication between adolescents and their parents. Ethical and Legal Issues in Adolescent Pregnancy. Careers. Therefore, research on adolescents reproductive health can lead to development of interventions that can maximize adolescents health potentials. HHS Vulnerability Disclosure, Help Clipboard, Search History, and several other advanced features are temporarily unavailable. National Health Research Ethics Committee of Nigeria. The site is secure. The site is secure. 2016. Paavonen J, Naud P, Salmern J, et al. Inclusion in an NLM database does not imply endorsement of, or agreement with, 8600 Rockville Pike Doctors who examine teenagers usually find that their patients come in fairly late, and some teenagers may carry their pregnancy to term while others request abortions as late as the 2nd trimester. 3 0 obj The peculiar challenges of applying fundamental ethical principles for adolescents engaged in research especially in cultures sensitive to open and public discussions about sex and sexuality, and how to resolve them can only be learnt from practical field experiences. Emancipated minor. PMC Ethical and legal issues in adolescent medicine. Preface A review of the health consequences of adolescent pregnancy indicates that pregnancy in adolescents has a higher mortality rate than that of legal abortions. There is also tension around how to manage confidentiality when the setting has laws about disclosures that must be reported to authorities e.g. Accessibility Key Words: Adolescents, reproductive health, ethical issues, United States, Informed Consent Katherine Ferrell Fouquier, CNM, PhD, FACNM University of Mississippi Medical Center MeSH PDF. Ethical and legal issues in adolescent pregnancy - PubMed They represent one fifth of the worlds population in general but constitute a larger proportion of the population of low and middle income countries (LMIC) compared to developed countries.1 Individuals aged 10 to 19 years constitute 11% of the population of the more developed countries, 18.1% of middle income countries and 23% of the least developed countries (US Census Bureau). Centre for Values, Ethics and the Law in Medicine, University of Sydney, New South Wales, Australia. HHS Vulnerability Disclosure, Help This consultation is also likely to occur if there are no clear therapeutic benefits accruable from participation in such studies, as it is the case for many HIV prevention research. In: Nortj, N., Bester, J.C. (eds) Pediatric Ethics: Theory and Practice . Silber, T., A. English (eds). (PDF) Researching young children's perception of food in Irish pre An exploration of the ethical, legal and developmental issues in the care of an adolescent patient. 1980 Jul;50(3):446-453. doi: 10.1111/j.1939-0025.1980.tb03304.x. In extraordinary circumstances, however, there may be a need to disclose information divulged by a minor during research to the legal caregiver. endobj Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Legal and Ethical Issues in the Provision of Adolescent Reproductive Adolescents also face sexual violence; a recognised growing problem and a leading sexual and reproductive health issue. Wheeler R. Gillick or Fraser? Would you like email updates of new search results? This is a preview of subscription content, access via your institution. Secondly, there is also another dimension to parental consent which adds a later of challenge to parental consenting. [Accessed 3rd May, 2011]; Position paper of the scientific and ethical review group on reproductive health involving adolescents. HHS Vulnerability Disclosure, Help The rights of minors to give consent to medical care is expressed in the mature minor doctrine and has been extended, with some limitations, to the abortion decision. Committee Opinion Number 803: Confidentiality in Adolescent Health Care. Confidential health care for adolescents: position paper of the Society for Adolescent Medicine. (2022). National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Counseling is available for adolescents unsure of what decisions to make the unable to get support from their families. Adolesc Med State Art Rev. At the social level, younger adolescents differ from adults in significant ways that could eventually affect how they will use sexual and reproductive health products. 8 0 obj An adolescent with an eating disorder. Experience of sexual coercion among adolescents in Ibadan, Nigeria. In Nigeria, the National Health Research Ethics Code provides limited guidance on this. The Child Rights Act5 however, provides that a child who has attained the age of 16 years has the right to give consent for scientific investigation without parental consent. The vast majority of countries set the legal age at 18, but from the age of 14 years adolescents' capability for medical decision-making may be considered already similar to adult capacity. There is a growing body of evidence to show that adolescents can be safely engaged in sexual and reproductive health research howbeit these examples are almost exclusively limited to USA. Bioethical and legal issues of termination of pregnancy resulting from It may be inappropriate to assume that all 14 year olds in Nigeria should be excluded from parental consent prior to engagement in sexual and reproductive health research. 2007 Dec;18(3):571-81, viii-ix. 2014 Feb;54(2):183-9. doi: 10.1016/j.jadohealth.2013.07.028. Ethical and Legal Issues in Adolescent Pregnancy Committee, and on practice and ambulatory medicine. The Nigeria Adolescent Health policy accepts the adolescent age range as the second decade of life, 1019 years2 in line with the definition by the World Health Organization3. The .gov means its official. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Bull Am Acad Psychiatry Law. The ethical dilemma of engaging adolescents in research in general, and sexual and reproductive health research specifically, is intertwined with legal and regulatory issues. To help inform ethical and safety recommendations for the design, conduct, and reporting of . A review of the health consequences of adolescent pregnancy indicates that pregnancy in adolescents has a higher mortality rate than that of legal abortions. article describes issues surrounding legal and ethical issues of informed consent and confidentiality for adolescents seeking reproductive health services. Ethical and Legal Issues in Adolescent Pregnancy - theclinics.com Adolescents and youth in developing countries: Health and development issues in context. Ford, C., A. English, and G. Sigman. A comparison of minors' and adults' pregnancy decisions. Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria. A review of the health consequences of adolescent pregnancy indicates that pregnancy in adolescents has a higher mortality rate than that of legal abortions. Legal and Ethical Issues in the Provision of Adolescent Reproductive Health in the United States Tomas J. Silber. Essack Z, Slack C, Strode A. Overcoming key obstacles to adolescent involvement in HIV vaccine and microbicide trials: A roadmap for stakeholders. sharing sensitive information, make sure youre on a federal The Nigerian population is young with well over 55% of the population below 29 yrs.16 There is therefore the need to pay particular attention to the health needs of this population. Impact of three years training on capacity of ethics committees in Nigeria. The parents insist on forcing her to drink milk by any means necessary, as it would be good for her health. Maternal, newborn, child and adolescent health: adolescent development. Predicting adult obesity from childhood obesity: A systematic review and meta-analysis. J Med Ethics. 2004. https://www.hrw.org/report/2008/03/24/adults-their-time/children-saudi-arabias-criminal-justice-system. To keep or not to keep? Decision making in adolescent pregnancies in It states that: Some studies involve investigation of adolescents beliefs and behaviour regarding sexuality or use of recreational drugs; other research addresses domestic violence or child abuse. In practice, adolescents aged 15 years are regularly engaged in national surveys on HIV prevalence.6 While it is recognized that a constitutional pronouncement supersedes all other ordinances and pronouncements, these disparities in pronouncements and practice all recognize a particular need of older adolescents when it comes to health care research. PubMedGoogle Scholar. The https:// ensures that you are connecting to the and transmitted securely. https://doi.org/10.1038/nature25770. Log in or Register Ethical and legal issues in adolescent pregnancy. This kind of discussion obviously compromises the adolescents privacy. 33. Ringheim K. Ethical and human rights perspectives on providers obligation to ensure adolescents rights to privacy.
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