Adolescent Brain Development and Medical Decision-making

Pediatrics. 2020 Aug;146(Suppl 1):S18-S24. doi: 10.1542/peds.2020-0818F.


With a few notable exceptions, adolescents do not possess the legal authority to provide consent for or refuse medical interventions. However, in some situations, the question arises regarding whether a mature minor should be permitted to make a life-altering medical decision that would be challenged if made by the minor's parent. In this article, I explore what we currently know about the adolescent brain and how that knowledge should frame our understanding of adolescent decision-making. The prevailing approach to determining when adolescents should have their decisions respected in the medical and legal context, an approach that is focused on establishing capacity under a traditional informed consent model, will be reviewed and critiqued. I will suggest that the traditional model is insufficient and explore the implications for the adolescent role in health care decision-making.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Adolescent Development*
  • Age Factors
  • Brain / growth & development*
  • Clinical Decision-Making*
  • Female
  • Hodgkin Disease / drug therapy*
  • Humans
  • Informed Consent / legislation & jurisprudence
  • Informed Consent / psychology*
  • Mental Competency / legislation & jurisprudence
  • Mental Competency / psychology
  • Mothers
  • Patient Self-Determination Act
  • Personal Autonomy
  • Treatment Refusal / legislation & jurisprudence
  • Treatment Refusal / psychology*
  • United States