In the case study, the major moral issues that the mother has a right to and responsibility to ensure her child is treated and recovers from the addiction. It is morally wrong for a parent to have to watch her child suffer and get lost in drugs. Besides, the primary responsibility of parents to their child is to ensure their welfare.  The facts are that Denise is a minor who is sixteen years old and still under the care of her mother and that Denise is a serious drug user who heavily uses alcohol and marijuana. Her mother is thus a legal guardian and thus is the rightful medical decisions maker for Denise in the case of her treatment. The conceptual issue is that Denise is refusing care against medical advice and her mother’s wishes and whether he should be able to decide to leave the residential treatment facility as a minor and an addict. Denise is a minor and being an addict, and his mental state is questionable in its ability to make the right decisions for his treatment.  Her mother is the more reliable person to make the medical decisions regarding her addiction treatment at the moment. The major stakeholders in the case are Denise, her mother and the medical practitioner at the residential health facility.

There are two options in the case. For one, Denise’s mother to be the medical decision maker in which case Denise if held at the residential facility under her mother’s instruction or for Denise to be let to leave as she wishes in which case her autonomy in medical care is taken into account and she is considered as of capacity to make medical decisions. Policies regarding the medical care of minors and drug addicts are significant to respond to the issues in the case. Most of the facts for the case are well known and thus it is possible to make decisions. The best option in the case is for Denise to receive the treatment she needs before its too late and thus her mother’s wishes and the medical advice should be executed over her autonomy in the decision making process.

Does alcohol and drug use uniquely affect an adolescent’s ability to make decisions about medical care for addiction; and, if so, should clinical and legal standards consider this factor?

Alcohol and drug use does affect an adolescent’s ability to makes decisions. Brain development is critical at adolescents, and it promotes risk-taking which results in the early drug use among teenagers. One of the risk factors associated with the onset of drug use is age and adolescents are the most vulnerable which explains why adolescents make up the highest population of marijuana and alcohol users and abusers (Winters and Arria, 2011). According to Winters and Aria, the brain develops through many connections before teenage and begins to sculpt at the age of eleven (Winters and Arria, 2011). The explanation by the authors means that the brain continues to grow significantly during teen years and any substance taken at the time affect the processing of the brain development process. Thinking and learning skills are still under development through the teen years and thus still being learned. Addiction and serious drug use is a condition that changes the function of the brain through drugs modifying the regions of the brain that seek goals and those responsible for self-control by changing the structure of the brain in the regions physically (Lewis, 2017). The regions are modified to seek the drug one is addicted to and thus altering the decision-making model of the individuals. For a teen, given that the brain is still developing and the brain is acquiring learning and thinking skills, the brain learns the drug as the goal it seeks and develops with that learning thus the discrediting the decision-making capacity of the teenagers. Therefore, legal and clinical standards should take brain development and adolescents’ ability to make decisions into consideration in developing policies around medical; decision making.

What if Denise had been arrested for drug possession with intent to distribute, placed in the juvenile justice system, and required to attend residential treatment. How should clinical care decisions and concepts of autonomy be addressed in the legal framework for juvenile justice drug treatment?

If Denise had been arrested, the clinical decisions would have been made to her best interest as a minor. In the juvenile system, her mother’s wishes would prevail as the legal guardian so long as they are for the best interests of the minor and be enforced by law and she would have to take the residential treatment legally as part of her juvenile program. Under juvenile justice drug treatment, the legal principles of informed consent and rights of children and their parent in medical decision making would be the guideline for Denise case, and thus a role in decision making would be irrelevant. According to the basic legal guidelines, children and minors are considered incompetent of giving informed consent and their parents, believed to hold the best interests of the child, are the principal decision makers (Boldt, 2012). Therefore, The parent’s decision would take the lead in the case, and Denise’s autonomy would be irrelevant in the case.

References

Boldt, R. C. (2012). Adolescent decision making: Legal issues with respect to treatment for substance misuse and mental illness. J. Health Care L. & Pol’y, 15, 75.

Lewis M. (2017). Addiction and the Brain: Development, Not Disease. Neuroethics, 10(1), 7–18. doi:10.1007/s12152-016-9293-4

Winters, K. C., & Arria, A. (2011). Adolescent Brain Development and Drugs. The prevention researcher, 18(2), 21–24.