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. Am J Orthopsychiatry. In this paper, we will consider whether the need for more information about adolescent sexual and reproductive health justifies a lowering of the legal age of consent in Nigeria. Retrieved from https://www.hrw.org/report/2008/03/24/adults-their-time/children-saudi-arabias-criminal-justice-system. Ethical issues in adolescent pregnancies Int J Gynaecol Obstet. Ethical guidelines have however, traditionally treated adolescents as vulnerable, meaning their capacity to give consent without duress may be easily compromised and therefore requires special protection as a group. Fetal viability as a threshold to personhood. Minor Minors (under age 18) do not have same constitutional rights as adults: vulnerability of children limited decision-making capacity important role parents plan in making decisions for their children Allowable treatment of minors without parental consent x\mo8 "ERKfMp7cJ{fb7plKgr~drE$Z-wgoc7g The https:// ensures that you are connecting to the Federal government websites often end in .gov or .mil. One successful example is the Adolescent Trial Network funded by the National Institute of Health (NIH). There is also tension around how to manage confidentiality when the setting has laws about disclosures that must be reported to authorities e.g. From the obstetrical point of view, abortion is the interruption of pregnancy, spontaneous or provoked, with up to 22 weeks of gestation and/or with the fetus weighing up to 500 g 1.. From a Brazilian legal point of view, abortion is the interruption of pregnancy with the destruction of the product of conception, regardless of gestational age or fetal weight and whether the pregnancy is . The ethical dilemma of engaging adolescents in research in general, and sexual and reproductive health research specifically, is intertwined with legal and regulatory issues. As we shall elaborate later in this paper, data cannot be extrapolated from other populations because adolescent experiences are particular to their societal context, shaped by factors including gender expectations and the socialisation processes at family levels17. sharing sensitive information, make sure youre on a federal As of 2019, adolescents aged 15-19 years in low- and middle-income countries (LMICs) had an estimated 21 million pregnancies each year, of which approximately 50% were unintended and which resulted in an estimated 12 million births (1) (2). Adolescent refusal of lifesaving treatment: Are we asking the right questions? PMID: 2755733 DOI: 10.3928/0090-4481-19890401-05 Abstract National Health Research Ethics Committee of Nigeria, Federal Ministry of Health, Department of Health Planning and Research. 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. PMID: 23045415 Abstract This review examines confidentiality, consent to health care and research involving adolescents in regard to legal and ethical aspects. {"type":"clinical-trial","attrs":{"text":"NCT00213083","term_id":"NCT00213083"}}. The University of Texas MD Anderson Cancer Center, Houston, TX, USA, UNLV School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV, USA, Barone, S., Unguru, Y. The World Health Organisation provides comprehensive guidelines on engagement of adolescent in research which could serve as a useful guide for research protocol review.45, While the ethical-legal framework for consent is specified in Nigeria, its understanding and application by ethics reviewers needs to be addressed through trainings. This decision is influenced by the feelings of the pregnant woman towards the pregnancy, socio . https://doi.org/10.1007/978-3-030-86182-7_10, DOI: https://doi.org/10.1007/978-3-030-86182-7_10, eBook Packages: Religion and PhilosophyPhilosophy and Religion (R0). Careers. A comparison of minors' and adults' pregnancy decisions. 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. 2011. Federal government websites often end in .gov or .mil. Dahl, R.E., N.B. application/pdf <>/MediaBox[0 0 612 792]/Parent 3 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Tabs/S/Type/Page>> These factors can affect their understanding of risks and their capacity to make consistently sound judgments about their long-term best interest. To keep or not to keep? Decision making in adolescent pregnancies in sharing sensitive information, make sure youre on a federal Pediatric Ethics: Theory and Practice pp 155169Cite as, 4 Bethesda, MD 20894, Web Policies PIP: <>/MediaBox[0 0 612 792]/Parent 3 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Tabs/S/Type/Page>> 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. Before Counseling is available for adolescents unsure of what decisions to make the unable to get support from their families. 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 many ways, therapy with children and families requires the highest standard of ethical behavior because of the special vulnerabilities of children and the complexities involved with interacting with multiple family members. 44 0 obj International Ethical Guidelines for Biomedical Research Involving Human Subjects. Scientific experts also need to clarify the differences in adolescent and adult sexual and reproductive health issues thereby justifying adolescents engagement in sexual and reproductive health research. Wheeler R. Gillick or Fraser? The .gov means its official. Ethics in Health Research: Principles, Structures and Processes. Ethical and definitional considerations in research on child sexual The ethical requirement is that informed consent must be voluntarily obtained and devoid of undue inducement and coercion. This is a preview of subscription content, access via your institution. 2015;24(3):166-176. doi: 10.1080/1067828X.2013.777380. Unable to load your collection due to an error, Unable to load your delegates due to an error. Applying specific and individual test of competency, and documenting it, has a clear advantage over agespecified restrictions in that it recognises the developmental and cognitive differences that exist within groups of young people who mature at different rates. Birkeland MS, Melkevik O, Holsen I, Wold B. Adults before their time: Children in Saudi Arabias criminal justice system. Developing guidance for pregnancy testing of adolescents participating Ajuwon AJ, Olley BO, Akin-Jimoh I, Akintola O. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. PubMedGoogle Scholar. 1990. 13 0 obj https://doi.org/10.1001/virtualmentor.2005.7.3.ccas2-0503. 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. While the parent may have given consent to the adolescents participation in research, the onus is on the researchers to keep all information provided by the adolescent confidential. Would you like email updates of new search results? Psychiatric Clinics of North America. Unable to load your collection due to an error, Unable to load your delegates due to an error. For many communities in Nigeria, parents may want to talk with their families or respected people in their community before reaching a decision about providing consent for an adolescent to participate in a sexual and reproductive health research, especially when such research involves invasive procedures such as regular blood draws and vaginal examinations. (PDF) Researching young children's perception of food in Irish pre Special Episode: A Second Trump Indictment - The New York Times October 1984 Counseling and Values. The engagement of 16 year old adolescents in the Carraguard study is a step in this direction.49 The proposed engagement of adolescents in post CAPRISA 004 studies is also one effort in this direction.50 Locally, adolescents have long being engaged in multiple social science and epidemiological researches. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Perceived facilitators of and barriers to mental health treatment engagement among decision-making competent adolescents in Greece. Appligent AppendPDF Pro 5.5 Correspondence to J Med Ethics. Ethics is an ever evolving field and ethical consideration of adolescents engagement in sexual and reproductive health research shall continue to constitute central themes in many ethical discourses for a while to come. Minors assent or dissent to medical treatment. Adolescent Medicine 0025--7125/90 $0.00 + .20 Treating Adolescents Legal and Ethical Considerations Abigail English, JD* The legal status of adolescents differs markedly from that of both younger children and adults. Ajuwon AJ, Olaleye A, Faromoju B, Ladipo O. The Ethical Issue. There have been two such studies by the Microbicide Trials Network conducted in USA and Peru and funded by NIH. Department of Child Dental Health and the Institute of Public Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria, Centre for Values, Ethics and the Law in Medicine, University of Sydney, New South Wales, Australia, Behavioral and Social Sciences with the Population Studies and Training Centre, Browns University, USA, Positive Action for Treatment Access, Lagos, Nigeria, Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria, Program in Public Health, Department of Population Health & Disease Prevention, University of California, Irvine. To succeed at enrolling adolescents in research, it may be important to extensively engage adolescents, youth and parents in research design and implementation to promote recruitment and retention of adolescents in the research. Virtual Mentor 7 (3): 213217. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. Child Development 53 (6): 15891598. Based on 2019 data, 55% of unintended pregnancies among adolescent girls aged 15 . Weithorn, L.A., and S.B. In this paper, we consider the ethical and legal issues posed by pregnancy testing in such individuals and suggest how guidance might be framed. However, it must be recognized that adolescence is a combination of physical, psychological and social changes that manifest differently in different cultural settings. <> Treating Adolescents: Legal and Ethical Considerations
Elden Ring Misericorde Crit, War Thunder Player Search, Hotel Near Pines Manor In Edison Nj, Articles E