ethical and legal issues in adolescent pregnancy
Each of these periods is defined by unique cognitive and physical developmental attributes that are on a continuum: early adolescence is cognitively dominated by concrete thought processes, with limited ability to comprehend potential consequences of risk behaviors while middle adolescence is characterized by the emergence of abstract cognitive processes, which revert to concrete thinking during stress.23 By mid adolescence (normally around the ages of 14 to 16), the cognitive abilities of adolescents are roughly the same as biologically mature adults. 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. official website and that any information you provide is encrypted sharing sensitive information, make sure youre on a federal The Ethical Issue. Bookshelf In this paper, we consider the ethical and legal issues posed by pregnancy testing in such individuals and suggest how guidance might be framed. Involving adolescents in research should be based on a careful assessment of risks and benefits together with understanding of the developing capabilities of the adolescent. Background While critically important, child sexual violence (CSV) research poses numerous ethical and safety challenges. 2011. 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 site is secure. Appligent AppendPDF Pro 5.5 2020a. 1993 Summer;12(3):498-511. Legal and ethical issues facing adolescent health care professionals. The site is secure. Clipboard, Search History, and several other advanced features are temporarily unavailable. Ann Emerg Med. Adolescent pregnancy is a global health issue. Azzopardi, D. Wickremarathne, and G.C. Olawunmi Fatusi, Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria. These trainings are conducted in a way that ensures knowledge and skills acquired are applicable to other research field.46. 2005 May;89(2):179-84. doi: 10.1016/j.ijgo.2005.01.038. Ringheim K. Ethical and human rights perspectives on providers obligation to ensure adolescents rights to privacy. Consultation and engagement of the community prior to research protocol submission to the ethics committee creates the opportunity to discuss the rationale underpinning the inclusion of adolescents in the research, as well as the reasons for not making parental consent for an adolescents participation in a study a requirement where such is the case. Prevention of pregnancy and children of reproductive age, as well as child marriage, are part of the SDG agenda with specific indicators, including indicator 3.7.2 "Adolescent birth rate (aged 10-14; aged 15 to 19) per 1000 women in this age group" and 5.3.1, "Proportion of women aged 20 to 24 married before age 18." Such an individual is assumed to have the capacity to understand the nature and consequences of the proposed treatment and has is adjudged to have the competency to understand what it takes to participate in a research. application/pdf The site is secure. Diekema, D.S. The constitution also recognises married adolescents who are below the age of 18 years as emancipated minors. For example, the appropriateness of including adolescents in research when the risks are more than low or minor increase over minimal is a difficult and thorny ethical issues. For studies on these topics, ethical review committees may waive parental permission if, for example, parental knowledge of the subject matter may place the adolescents at some risk of questioning or even intimidation by their parents (CIOMS, 2002).42, Zuch et al also further highlighted the challenges associated with parental consent for all forms of research engaging adolescents. 2017-12-13T07:30:31-08:00 It is however possible that ethics review committees waive a requirement for parental permission for adolescent participation when there are compelling reasons warranting this action. Heffron R, Donnell D, Rees H, Celum C, Mugo N, Were E, de Bruyn G, Nakku-Joloba E, Ngure K, Kiarie J, Coombs RW, Baeten JM for the Partners in Prevention HSV/HIV Transmission Study Team. Tools. 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. 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. 1980 Jul;50(3):446-453. doi: 10.1111/j.1939-0025.1980.tb03304.x. Hardin, A.P., and J.M. Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria. Careers. Health Psychology 9 (6): 701716. Unauthorized use of these marks is strictly prohibited. 8600 Rockville Pike Ethical considerations concerning adolescents consulting for contraceptive services. HHS Vulnerability Disclosure, Help These factors can affect their understanding of risks and their capacity to make consistently sound judgments about their long-term best interest. Careers. The International Library of Bioethics, vol 89. Pediatr Clin North Am. The .gov means its official. Ethical and legal issues in adolescent medicine. Preface The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). J Pediatr 2021:231;24-30. Within the Nigerian legal context, parental consent and assent for adolescents below the age of 16 years are needed before participation in any form of research except for mature minors. <>/ProcSet[/PDF/Text]>>/Type/Page>> An official website of the United States government. 2 0 obj AppendPDF Pro 5.5 Linux Kernel 2.6 64bit Oct 2 2014 Library 10.1.0 2007 Dec;18(3):571-81, viii-ix. Are adolescents less mature than adults? Casey, B., R.M. http://www.unicef.org/media/files/PFC2012_A_report_card_on_adolescents.pdf, http://www.who.int/features/factfiles/adolescent_health/en/index.html, http://www.global-campaign.org/researchethics.htm, http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html, http://www.cioms.ch/frame_guidelines_nov_2002.htm, http://www.who.int/reproductivehealth/topics/ethics/adolescents_guide_serg/en/index.html. Read the full text. Accessibility endobj Ethical questions in adolescent contraception. Summary This chapter introduces the legal and ethical considerations for the advanced practice registered nurse (APRN) providing care to children in primary care settings and suggests methods for r. Legal and Ethical Issues - Child and Adolescent Behavioral Health - Wiley Online Library Skip to Article Content Skip to Article Information This implies that people under the age of 18 years have limited legal capacity and are vulnerable to decision making that is not fully competent. Adolescent abortion and mandated parental involvement. https://doi.org/10.1037/a0014763. sharing sensitive information, make sure youre on a federal 2017-12-13T07:30:31-08:00 There have been two such studies by the Microbicide Trials Network conducted in USA and Peru and funded by NIH. 8600 Rockville Pike 3 0 obj Ethical issues in adolescent pregnancies - - 2015 - International Rudy BJ, Kapogiannis BG, Lally MA, Gray GE, Bekker LG, Krogstad P, McGowan I. Youth-specific considerations in the development of preexposure prophylaxis, microbicide, and vaccine research trials. Unauthorized use of these marks is strictly prohibited. Journal of Adolescent Research 21 (1): 2133. Before Heise LL, Wood SY. Unguru, Y. [Accessed 3rd May, 2011]; Position paper of the scientific and ethical review group on reproductive health involving adolescents. Fatusi AO, Blum RB. 2004. As noted, a parent may give consent for enrolment, but adolescents may expect confidentiality for some components (such as their risk behaviour). Steinberg, L., E. Cauffman, J. Woolard, S. Graham, and M.T. Ajuwon AJ, McFarland W, Hudes S, Adedapo S, Okikiolu T, Lurie P. Risk-related behavior, sexual coercion and implications for prevention strategies among female apprentices tailors in Ibadan, Nigeria. Accessibility One of the several rationales for biomedical or socio-behavioural research is that it may lead to discovery of information that can guide the implementation and delivery of appropriate preventive and therapeutic services to the particular population studied. Nature 554 (7693): 441450. Ethics in Health Research: Principles, Structures and Processes. The site is secure. Its activities encompass the full spectrum of research needs for adolescents including clinical management of HIV-infected youth and risk reduction. Positive Action for Treatment Access, Lagos, Nigeria. There is also tension around how to manage confidentiality when the setting has laws about disclosures that must be reported to authorities e.g. Cunningham CK, Rudy BJ, Xu JJ, et al. These biological differences make it important to conduct health research amongst adolescents as it is equally important to under geriatrics and their health related problems.20. National Health Research Ethics Committee of Nigeria, Federal Ministry of Health, Department of Health Planning and Research. [Accessed 17th May 2013]; efficacy study of the vaginal gel Carraguard to prevent HIV transmission. Author FIGO Committee for Ethical Aspects of Human Reproduction and Women's Health PMID: 25458417 DOI: 10.1016/j.ijgo.2014.10.006 Adolescent Ethics, Medical* Female Humans Pregnancy Legally, these caregivers may not be recognized as the legal guardian. As medical evidence shows, cognitive development of the adolescents is near that of the adult by 14 years such that decision making and reasoning ability is as good as that seen in adulthood and involves the flaws.44 It may therefore be important to advocate for changes in the law so it can permit adolescents 15 years and above with proven evidence of sufficient maturity, and with the mental capacity to understand the benefits, risks, and social and other implications of the outcome, to participate in research in general and sexual and reproductive health research specifically, without parental consent. Preconventional behavior may consist of worry about the reactions of individuals holding power over the adolescent's life; conventional behavior may consist of the adolescent conforming, as well as maintaining societal rules; and postconventional behavior may consist of the wishes of the adolescent outweighing societal expectations in their decision-making. DOI: 10.1016/s0025-7125(16)30504-1 Abstract Treating adolescents in the health care system raises significant legal and ethical issues related to consent for treatment, confidentiality of communications and records, and payment for care. Citations: 2. Publicly funded programs provide access to free care for some adolescents, but financial considerations continue to limit access for many poor and low-income adolescents. endobj Pediatrics 140 (3). %PDF-1.7 % Confidential Care for Adolescents in the U.S. Health Care System and transmitted securely. It explicitly states in the section F(c) that minors should not be excluded from research without explicit reasons for doing so.32 Unfortunately, the code is not explicit about age for consent and assent. Adolescence is divided into 3 broad developmental periods: early (1114 years), middle (1517 years), and late (1819 years) recognizing that there will of course be individual variation as to when there periods begin and end. In extraordinary circumstances, however, there may be a need to disclose information divulged by a minor during research to the legal caregiver. Ethical considerations for working with runaway and homeless youth in research and treatment settings are presented. American Academy of Pediatrics 22 (2). Clinics in Perinatology, 14 \(1987\) 265-270. doi:10.1016/S0095-5108\(18\)30763-2. First, there is also the legal dilemma of who provides parental consent. official website and that any information you provide is encrypted Pharmacokinetics of antiretroviral regimens containing tenofovir disoproxil fumarate and atazanavirritonavir in adolescents and young adults with human immunodeficiency virus infection. Please enable scripts and reload this page. 8 0 obj An ethical perspective.
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ethical and legal issues in adolescent pregnancy
