The Role of Religion in Decision Making

Under many jurisdictional laws, a person is deemed a child until they reach the age of 18 while different religions peg the definition to the different teachings that they adhere to. As concerns the first, it has become the norm across the western world for the larger society’s considerations that limit various decisions that view those under eighteen years as children and as such, transfer the decision-making capabilities for them to their parents and or guardians as concerns the health decisions. Further, under different religions, the same decision-making process takes a different form where Christianity aligns itself to the above-proscribed age while Islam pegs this differently as defined by gender. (Parsapoor, Parsapoor, Rezaei, & Asghari, 2014) indicate that despite age, most children take part in decision making under Christianity and under western laws while those born into Islamic religion are given autonomy in medical decision making at the ages of fifteen and nine for boys and girls respectively.This paper discusses the medical rights and autonomy that children have in decision making as pertains to their medical rights by concentrating on the instances that they can override parental or guardian decisions, religious beliefs and the selection of proxy decision makers towards obtaining their health care needs.

II. Overriding Parental Decisions

The hallmarks of informed choice in the provision of healthcare require that appropriate information, decision-making capability and voluntariness are present at all times (Canadian Paediatric Society, 2004). To this end, delivery of health care requires the physician, child, and guardian to be able to supply sufficient information accurately to enable proper diagnosis and thus result in the proper treatment of the ailment that a child suffers from. To this end, a lot is expected fro the child since they are best placed to describe how they are feeling and their parents can only provide information obtained from either observation or oral narration from the child. However, the decision-making capacity of the child limits their actual ability to comprehend the purpose and hence the selection of the intervention method required for them to get the required intervention since this process requires the ability to comprehend the magnitude of the harm or benefit that the child will get from the prescribed treatment. Further, as concerns voluntariness, healthcare delivery directly relies on what a patient considers as either right or wrong and as such, the importance of medical decisions cannot be left to the child.(Canadian Paediatric Society, 2004). The above indicates that children lack the capacity to make informed decisions as concerns their medical decisions since they are are assumed to lack the capacity to comprehend the magnitude of the harm or benefits obtained from treatment as well as a lack of voluntariness albeit them being able to provide appropriate information, although this can be limited in certain situations, to the physicians. However, in the decision-making process, parents can be overruled by their children especially where they act as surrogates in ensuring that where children have expressed their wishes to them, that this is met during the provision of healthcare. Further, (Boonstra & Nash, 2000) indicate that despite the above, federal and state policies allow for children to make decisions as concerns areas such as contraceptive service and the testing and treatment of sexually transmitted diseases and alcohol and drug abuse

III. Religious Beliefs

Guardians and parents decisions are based upon religious beliefs and may not necessarily be in best interest of the child. As discussed above, while Christian parents hold the decision-making role in their children's medical care until they reach eighteen, Islam does not do so and as such, the role of religion in decision making can be seen to impact on healthcare in different functions. Further, where parents subscribe to religions that may view certain aspects of healthcare such as vaccinations, treatment of sexually transmitted diseases and even end of life as a call against their core religious beliefs, parents can deny their children access to the best available healthcare that they require. A case in point can be considered as regards abortion where many religions view its existence as an abomination and thus where they children have undergone the above, parents may deny their children the health care and psychological support systems required for the children to be re-absorbed into society as well as services that they may require to incorporate them back into society as healthy individuals. Further, instances do exist where children do not necessarily adhere to the religious beliefs of their parents and as such, a contradiction in accessing health care arises. For example, where a child is born in a Christian family decides to follow Islamic teachings, a number of areas as concerns the child’s healthcare will differ between the child and his or her parents.

IV. The child should be able to choose a proxy decision maker for situations.

Given the legal duty that parents have in ensuring their children access medical care, there are instances where the parent's decisions may not necessarily be in the best interest of the child. (Woods, 2003) discusses the implications of allowing parental decisions to be dictated by their own conscience and as such, overrule the greater good that is expected to be achieved for a child’s health. As such, state intervention is available where reasonably necessary Medicare for children is not provided for by their parents and as such, the state can act on behalf of the child where a parent fails. Further, (Diekema, 2017) indicates that where care providers note that the parents decisions do not reflect the best interest of the child, such decisions should be contested and as such, the selection of a surrogate or proxy decision maker should occur as discussed by (Woods, 2003) where state agencies intervene to ensure that a child receives treatment that balances the child’s best interest.

V. Conclusion

(Parsapoor, Parsapoor, Rezaei, & Asghari, 2014) indicate that the decision-making process should be considered as a developmental process that incorporates the existence of infants and young children, middle aged children, adolescents and emancipated and mature minors as regards the inclusion of children in the decision-making process. This incorporates the abilities of children and their guardians, regardless of religious beliefs and ability to provide appropriate information, decision-making capability and voluntariness to their physicians, through an understanding of how a child has developed in their decision making capability. This will allow for children to not only be passive participants who are only required to provide physicians with symptoms, but allows for children to be actively involved in their treatments based on their ability to comprehend benefits as well as the harm of selecting from the available treatment options.

References

Boonstra, H. D., & Nash, E. (2000, August 1). Minors and the Right to Consent to Health Care. Retrieved June 17, 2017
Canadian Paediatric Society. (2004). Treatment Decisions Regarding Infants, Children and Adolescents. Paediatrics Child Health, 99-103.
Diekema, D. S. (2017). Parental Decision Making. Retrieved from University of Washington School of Medicine: https://depts.washington.edu/bioethx/topics/parent.html
Parsapoor, A., Parsapoor, M.-B., Rezaei, N., & Asghari, F. (2014). Autonomy of Children and Adolescents in Consent to Treatment: Ethical, Jurisprudential and Legal Considerations. Iran Journal of Pediatrics, 241-248.
Woods, M. (2003). Overriding Parental Decision to Withhold Treatment. AMA Journal of Ethics.