maturity; for legal purposes, however, they are not the same. For the purposes of this appendix, and in accord with the general sentiments from common law, “mature minors” are typically defined as children who are seen as “sufficiently” mature (a subjective decision, made on a case-by-case basis) with the capacity to understand the risks and consequences of certain decisions and, hence, who have the ability to make those decisions, including, at times, decisions relating to medical treatment (Table B.4).8 The historical development of the “mature minor” doctrine in common law supports a distinction from emancipation, inasmuch as the former doctrine is of more recent vintage conferring more context-sensitive consent rights in children, for example, to consent to certain medical treatments.9

Age of Consent for Medical Care

Some youth, who are still technically “minors” under state law, are allowed to consent to general medical treatment under specific state statutory provisions [19]. For example, several states allow minors to make medical decisions when they hold sufficient capacity to understand the nature of the treatment [20]. A few states have set age limits younger than 18 years at which they allow minors to provide general consent for health care, such as 14 years (Alabama) [21], 15 years (California, Oregon) [22], and 16 years (South Carolina) [23]. Other states (e.g., Colorado, Indiana, and Maine) allow earlier consent to health care or treatment on the basis of certain events that indicate that the minor has sufficient decisional capacity, such as living separately and apart from the parents [24]. It is worth noting again, however, that statutes delineating conditions of sufficient decisional capacity should be distinguished from “emancipation” status. Emancipation represents a “legal” transition to adulthood in the eyes of the state, whereas decisional maturity represents a context-specific ability to consent in certain instances.10

8  

As commented upon by the American Law Institute, a prominent legal authority, in its Restatement (Second) of Torts, a minor’s consent should be effective if he or she is “capable of appreciating the nature, extent and probable consequences of the conduct consented to [e.g., medical treatment],” even if parental consent is “not obtained or is expressly refused” [18].

9  

This distinction (i.e., event versus context-sensitive maturity and the setting in which the decision is made) is followed in this paper.

10  

Again, however, it should be emphasized that the concept of “emancipation” in states is far from clear. For the purposes of this appendix, emancipation is seen as a transition to adulthood in state law, but researchers would need to consult experts in their own states for guidance on the bounds of emancipation in the respective states.



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