ABSTRACT
Although adolescent males have as many health issues and concerns as adolescent females, they are much less likely to be seen in a clinical setting. This is related to both individual factors and the health care system itself, which is not always encouraging and set up to provide comprehensive male health care. Working with adolescent boys involves gaining the knowledge and skills to address concerns such as puberty and sexuality, substance use, violence, risk-taking behaviours and mental health issues. The ability to engage the young male patient is critical, and the professional must be comfortable in initiating conversation about a wide array of topics with the teen boy, who may be reluctant to discuss his concerns. It is important to take every opportunity with adolescent boys to talk about issues beyond the presenting complain, and let them know about confidential care. The physician can educate teens about the importance of regular checkups, and that they are welcome to contact the physician if they are experiencing any concerns about their health or well-being. Parents of preadolescent and adolescent boys should be educated on the value of regular health maintenance visits for their sons beginning in their early teen years.
ABSTRACT
Confusion persists about when a minor can give informed consent to medical treatment. Physicians may be hesitant to treat minors, even as adolescents, without first obtaining parental or guardian consent for fear of being sued for battery or negligence. However, the common law in Canada is clear that a minor can give informed consent to therapeutic medical treatment, provided heorshe can understand the information regarding the proposed treatment and can appreciate the attendant risks and possible consequences. Courts have accepted that there is no precise age at which a minor can be presumed to have the capacity to give informed consent. Each minor must be individually assessed to determine whether he or she possesses the requisite maturity and level of understanding to comprehend the nature, benefits and risks of the proposed treatment. The responsibility for determining a minor's capacity rests with the physician or another health care provider who is seeking to obtain the informed consent. In the event that legal action is taken against the physician on the grounds the minor lacked the capacity to give informed consent, the court must be satisfied that the minor did have sufficient capacity. Examples of cases where the physician was sued by either the minor or the minor's parents are included. In addition, an overview of existing provincial legislation dealing with minors and informed consent is provided.
La confusion persiste au sujet du moment auquel un mineur peut donner un consentement éclairé au traitement médical. Les médecins peuvent hésiter à traiter les mineurs, même s'il s'agit d'adolescents, sans d'abord obtenir le consentement d'un parent ou d'un tuteur, par crainte de poursuites pour voie de fait ou acte de négligence. Cependant, au Canada, la Common Law établit sans équivoque qu'un mineur peut donner un consentement éclairé à un traitement médical thérapeutique s'il peut comprendre l'information reliée au traitement proposé et s'il peut en apprécier les risques inhérents et les conséquences possibles. Les tribunaux ont accepté qu'il n'y ait pas d'âge précis auquel un mineur est présumé capable de donner un consentement éclairé. Chaque mineur doit être évalué pour établir s'il possède la maturité nécessaire et un taux de compréhension suffisant pour saisir la nature, les avantages et les risques du traitement proposé. La responsabilité de déterminer la capacité du mineur incombe au médecin ou au professionnel de la santé qui cherche à obtenir le consentement éclairé. Si des actions en justice sont intentées contre le médecin sous prétexte que le mineur ne possédait pas la capacité de donner un consentement éclairé, il faut alors convaincre le tribunal que le mineur possédait bel et bien une capacité suffisante. Des exemples de cas au cours desquels le médecin a été poursuivi par le mineur ou ses parents sont inclus. En outre, on donne un aperçu des lois provinciales existantes portant sur les mineurs et le consentement éclairé.
