The will of young minors in the terminal stage of sickness: A case report

• Published in: Open medicine (Warsaw, Poland) Vol. 15; no. 1; pp. 513 - 519
• Main Authors: Fedeli, Piergiorgio, Giorgetti, Sergio, Cannovo, Nunzia
• Format: Journal Article
• Language: English
• Published: Poland De Gruyter 01-01-2020; Walter de Gruyter GmbH
• Subjects: Abdomen; Adrenal glands; Age; Bone marrow; Case reports; Chemotherapy; children; Informed consent; Legal medicine; Lymphatic system; Neuroblastoma; Pain; palliative sedation; Parents & parenting; Radiation therapy; neuroblastoma; informed consent; children; palliative sedation
• ISSN: 2391-5463; 2391-5463
• DOI: 10.1515/med-2020-0152

In Italy, both parents have parental responsibility, so they have the power to give or withhold consent to medical procedures on their children.
The present work reports the case of a 5-year-old boy diagnosed with neuroblastoma in the right adrenal loggia, who underwent several chemotherapy treatments that prolonged his life until the age of 10. Informed consent for treatments was requested exclusively of the parents, without taking into consideration the minor's will, not even when he asked for increased pain relief medication instead of other palliative treatments.
The authors thought it interesting to examine the case in the light of new Italian legislation on informed consent and to verify whether it promotes greater participation of minors in healthcare choices, given that the issue of acquisition of informed consent is becoming increasingly broad and complex.
The case examined here indicates that current Italian legislation, even including the modifications introduced, does not allow for concrete and active participation of minors, especially those under the age of 12, in the discussion of choices about their health, not even in choices regarding the end of life, and not even when the minor manifests a mature capacity for discernment.