Adolescents’ healthcare decisional capacity in the clinical context: a theoretical study and model

Autores da FMUP

• Rui Manuel Lopes Nunes

  Autor

Participantes de fora da FMUP

• Martins G.H.
• Eler K.
• Albuquerque A.

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina da Comunidade, Informação e Decisão em Saúde

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Objective: To provide a theoretical study and model for the bioethical foundations of the factors that influence adolescents' healthcare decisional capacity. Sources: Materials from diverse sources, including indexed articles in recognized databases and official government documents, were examined for a purposefully selected sample. The research consisted of two stages: selection of documents and reflective thematic analysis, followed by the preparation of a report. The analysis adopted a phenomenological stance and a reflective view compatible with human rights. To reduce bias and ensure the robustness of the results, measures such as data triangulation were employed. Ethical measures were taken to ensure data integrity, including considerations of anonymity and conflicts of interest in the selected studies. Summary of the findings: It was possible to list intrinsic and extrinsic factors of the adolescent patient that influence their decisional capacity regarding health. A theoretical model was developed to discuss these factors for evaluation by means of an infographic. Conclusions: It seems clear that the evaluation of healthcare decisional capacity of adolescents must position itself ethically regarding the tension between the moral duty to respect the self-determination of the able subject and the need to protect adolescents decidedly unable to make a specific health decision at a given time. © 2024 Sociedade Brasileira de Pediatria

Copyright © 2024 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Keywords

• adolescent; adult; bioethics; data base; data integrity; decision making; government; health care; human; human rights; medical ethics; morality; review; thematic analysis; theoretical model; theoretical study; triangulation