Supporting the Developing Autonomy of Youth Patients: Reflections on the Role of Healthcare Providers

Abstract

From the perspective of youth patients and decision-making about healthcare, several questions related to the value(s) of patient and family-centered care arise. It is relatively well-recognized that there is a need for both changes to, and transitions in, how healthcare is provided for youth, so as to correspond to the development of their abilities to make their own health decisions. In this chapter, I explore several issues related to this transition period both in the context of providing care for youth patients with chronic illness and from the perspective of the role of healthcare providers and their relationships with youth patients and parents. Ethics-based questions and concerns related to the nature of capacity and capacity assessments for youth patients, the possible (negative) role of assumptions about teenagers, and the need to further assist youth patients in navigating some of the possible mixed messages about what it means to become an adult are explored. Relevantly, consideration will also be given to whether the increased focus on the transition period for youth patients helps or hinders reflection on the degree to which healthcare providers are engaged appropriately in their relationships with youth patients and parents. Three cases to set the context for discussion are also included.