Although adolescence cannot be said to be a medical condition, and although most adolescents are healthy, some do become ill. But the adolescent is not a patient like any other...Today, the age of majority is set in mostjurisdictions at the age of 18 years, but in the context of medical treatment, many countries do recognise a certain level of autonomy (to a greater or lesser extent) of adolescents who are deemed to be mature. However, the extent of this autonomy raises many questions. Is the consent of the adolescent required, along with that of the parents, before any intervention may take place ? Do they have a right of veto? Is their consent alone enough? Are they recognised as having the right to take part in medical trials, the right to refuse necessary treatment...? These and many other questions are at the heart of this multidisciplinary and international study, which is the fruit of reflection and discussion between lawyers, philosophers, sociologists and child psychologists during the 2nd Workshop of the International Academic Network on Bioethics. The issues raised go well beyond law because they engender questions of the individuality of the adolescent and her ability to make choices when faced with illness and even her own death. Despite the complexity and depth of the subject, the chapters in this volume cleariy reveal the status of the adolescent in medical decisionmaking, in sixteen different countries. Despite obvious differences between the systems studied, the one thing that is clear is the graduai recognition of the adolescent's growing autonomy in medical decisionmaking which is not always expressly provided for in legislation. Such an evolution is hardly surprising at a time when the distinction between adolescence and adulthood is becoming Iess certain for many. Created in 2007, the IANB's objective is to promote research through collaboration between academic representatives from different countries and cultures, ail specialists in the field of biomedicine. Based upon a comparative approach of different legal systems, the work of the group analyses social choices in biomedicine through the different lenses of ethics, anthropology, philosophy and sociology. In this way, their research feeds into the elaboration and development of international regulation of biomedical practices and incidentally on achieving the balance between the respect for different cultures and the move towards a certain universality, supporting the harmonisation of laws. This new collection will therefore be indispensable for anyone seeking to understand the social implications of bioethics.

Adolescents, Autonomy and Medical Treatment - Divergence and convergence across the globe

Si l'adolescence n'est pas une maladie et si la plupart des ados vont bien, certains sont malades. Or, l'adolescent n'est pas un malade comme les autres... Aujourd'hui, l'âge de la majorité civile est fixé à dix-huit ans, mais en matière médicale, nombreuses sont les législations qui confèrent à l'adolescent doué de discernement une autonomie juridique plus ou moins étendue. A propos de celle-ci, d'innombrables questions se posent. L'adolescent sera-t-il appelé, à côté de ses parents, à consentir à un traitement médical ? Aura t-il simplement un droit de veto ? Son consentement, parfois, suffira-t-il ? Le droit de se prêter à une expérimentation, celui de refuser les soins susceptibles d'améliorer son état... lui seront-ils accordés ? Ces questions, et bien d'autres, sont au coeur de cette étude internationale et pluridisciplinaire, fruit des réflexions auxquelles se sont livrés ensemble, juristes, philosophes, sociologues, pédopsychiatres, lors du deuxième Workshop du Réseau Universitaire International de Bioéthique (RUIB). Souvent juridiques, les thèmes examinés vont bien au delà du droit puisqu'ils posent le problème de l'individuation de l'adolescent, de sa capacité à faire des choix face à la maladie, voire à la mort. Malgré la complexité et l'ampleur du sujet, les articles regroupés au sein de l'ouvrage exposent le plus clairement possible le statut actuel, dans seize pays, de l'adolescent face aux prises de décisions médicales. En dépit des divergences logiques entre les systèmes évoqués, une évidence se fait jour la consécration progressive d'une plus grande autonomie médicale de 'adolescent souvent non prévue par la loi. Une telle évolution n'étonnera guère à un moment où, dans des pays toujours plus nombreux, la frontière entre adolescent et adulte apparaît de plus en plus incertaine.

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