The mature minor doctrine, although it is sometimes controversial, has been successfully applied to teenagers and adolescents who sought to refuse a medical treatment, such as chemotherapy, because of a religious or other personal objection.
Here are five examples of its application.
1. Ernestine Gregory
While the law assumes an adult guardian or representative of the state has default control over decisions affecting a child's welfare, the Illinois Supreme Court ruled 5-2 in 1989
that a teenaged Jehovah's Witness with leukemia, Ernestine Gregory, could claim a mature-minor exception at age 17 and withhold her consent for blood transfusions.
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By the time the state's highest court decided, however, Gregory had already undergone the transfusions that had been mandated by a lower court, and her cancer was in remission, The Chicago Tribune reported
2. Starchild Abraham Cherrix
A 15-year-old cancer patient from Virginia named Starchild Abraham Cherrix fought the state to a draw in court in 2006 over chemotherapy, which Cherrix had sought to stop because he considered the treatment and its side effects worse than the disease, The Washington Post reported
Virginia officials agreed to let Cherrix pursue alternative therapies as long as he agreed to let a certified cancer specialist oversee the treatment. The case also galvanized support for Cherrix, and resulted in Virginia passing "Abraham's Law" in 2007, which expanded the rights of minors as young as 14 to refuse medical treatment, the Post reported
3. Dennis Lindberg
In 2007, a 14-year-old Jehovah's Witness from Washington state, Dennis Lindberg, died of cancer after refusing to accept blood transfusions, in keeping with his faith and despite his parents wishes that he undergo the treatment. Lindberg died after a judge had ruled that he was competent to decide for himself, The Seattle Post-Intelligencer reported
4. A.C. v. Manitoba
In 2009, the Supreme Court of Canada threw out a provincial law that no one younger than 16 could claim a mature-minor exemption. Ruling in A.C. v. Manitoba, Justice Rosalie Abella wrote
that a 14-year-old plaintiff was at least entitled to a hearing to have her "mature medical decisional capability" evaluated.
But the court also ruled that in this instance, child welfare officials were correct when they ordered an emergency transfusion to treat internal bleeding caused by the girl's Crohn's disease, despite the fact that she had filled out and signed an advance written directive stating that as a Jehovah's Witness she could not, for religious reasons, undergo blood transfusions — so the court declined to definitively say whether a child has a religious right to die, legal analyst Christopher Bird wrote for "The Court,"
the blog of Osgoode School of Law at York University in Toronto.
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5. Rule of Sevens
Proving the doctrine can cut both ways, a Tennessee doctor used it in 1987 to defend himself in court against a teenager he had treated for back pain. The teen went to the osteopathy practitioner without telling her parents and suffered injuries and complications that she said were caused by the treatment.
The state's Supreme Court sided with the doctor on the issue of consent, writing
that a lower court jury was justified in ruling that the minor "had the ability, maturity, experience, education and judgment at her 17 years, 7 months of age to consent knowingly to medical treatment."
The case established what ever after became known in Tennessee as the "Rule of Sevens," establishing the ages at which the law says children do and do not have the capacity to make decisions about their medical treatment, Contemporary Pediatrics reported in 2011
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