From the Guidelines
Allowing children to make their own bodily autonomy decisions regarding their physical health and well-being is crucial for their development and well-being, as it enables them to take ownership of their health and make informed decisions.
Benefits of Bodily Autonomy
- Improved self-efficacy and adherence: Shared decision-making with youth regarding their health can improve their self-efficacy, adherence, and metabolic outcomes, as seen in the management of diabetes 1.
- Better informed decisions: Educating adolescent girls about the risks of malformations associated with poor metabolic control and the use of effective contraception enables them to make well-informed decisions about their reproductive health 1.
- Enhanced autonomy and maturity: The "mature minor rule" acknowledges that children after age 12 or 13 years who appear to be "mature" have the right to consent or withhold consent to general medical treatment, except in cases where refusal would significantly endanger health 1.
Importance of Support and Guidance
- Psychosocial support: The presence of a mental health professional on pediatric multidisciplinary teams highlights the importance of attending to the psychosocial issues of diabetes and other health conditions 1.
- Education and resources: Providing developmentally appropriate educational tools and resources, such as those available through the ADA, can enable adolescents to make informed decisions about their health and well-being 1.
From the Research
Benefits of Bodily Autonomy for Children
The benefits of allowing children to make their own bodily autonomy decisions regarding their physical health and well-being include:
- Increased self-determination and bodily integrity, as children are more aware of their bodily autonomy and morality than previously assumed 2
- Improved health-related quality of life (HRQoL), as autonomy is recognized as important for individual well-being and constitutes one dimension in the KIDSCREEN-instrument measuring HRQoL in children and adolescents 3
- Enhanced ability to make informed decisions about their own health, as children's autonomy includes the right to influence outcomes and make choices about their own body 2, 4
- Better coping with health risks and health impairments, as personal autonomy is a unique predictor for a better health-related quality of life (KINDL-R) 5
Importance of Respecting Children's Autonomy
Respecting children's autonomy is crucial, as it:
- Involves patients being adequately informed and being able to accept or refuse proposed treatment, which is essential for their autonomy and decision-making capacity 2
- Requires adults to inform children and respect their initially instinctive efforts to protect their bodily integrity, as children are more aware of their bodily autonomy than previously assumed 2
- Can lead to improved health outcomes, as children who are involved in decision-making about their own health are more likely to have better health-related quality of life 3, 5
Shared Decision-Making and Autonomy
Shared decision-making (SDM) is an approach that can be used to involve children in decision-making about their own health, and:
- Can be beneficial for adolescents, whose emerging and relational autonomy is distinct from that of adults and children 6
- Requires a practical and stepwise approach, as well as guidance when SDM breaks down, to ensure that children's autonomy is respected and their decision-making capacity is supported 6