Bodily integrity is the principle that it is the right of each human being, including children, to autonomy and self-determination over their own body. Children who have been abused or neglected often feel little control over what happens to them. Children should be routinely involved in the process of making routine and non-routine treatment decisions, to the extent appropriate. These communications should occur in a developmentally appropriate, judgment-free manner and in a physical space offering confidentiality to ask questions and share concerns. Children may need multiple opportunities to ask questions and receive information in order to build skills to become capable and confident healthcare consumers. These interactions also offer the opportunity to assess the child’s level of understanding about what to expect with tests or treatment and to help them develop awareness about their physical and mental health. At minimum, children should be offered the opportunity to:
- Know their diagnosis
- Understand all the treatment options
- Ask questions about potential benefits and side effects
- Participate in decision-making to the extent that is developmentally appropriate
- Receive assistance from the family support team to help with decisions
- Obtain or refuse birth control
- Consent to substance abuse treatment when 16 years of age or older
- Refuse psychotropic medication after being offered the opportunity to consult with their healthcare provider
Youth 18 Years or Older: Once a youth has reached 18 years of age, the ability to give consent or refuse treatment shall transfer from the case manager to the youth. The case manager should be available to answer questions and assist the youth in making an informed decision. The only exception to this is if a court order has been obtained that such a transfer would not be in the youth’s best interest due to incapacity or disability. In that event, the case manager should continue as the consenter but involve the youth in the decision-making process to the greatest extent possible.