A study of the ethical significance of childhood in the context of adolescent decisions in medical care

Are contemporary models of health-care eroding the importance of children in Western cultures? Are we losing a sense of the ethical significance of childhood? And by extension, has a sense of personhood already been discarded when it comes to the granting of faculties for giving consent to medical treatments in cases of under-age and adolescent patients? This project makes a study of the ethical significance of childhood in the context of differing perspectives on what precisely is a person and what constitutes childhood, with a focus on adolescence. The fundamental choices made regarding children from the point of conception onwards have taken new directions amid a variance of ethical systems, including the practice of sex-selective abortions, transhumanist tendencies in the construction of what is perceived to be “human”, the treatment of disabled neonates, new arguments for infanticide, and complex new arrangements for parenting roles and legal recognition of non-traditional parental relationships and family structures. Questions such as, ‘what is a child?’ and ‘what respect’, if any, ‘is owed to a human embryo’ open to a plurality of contradictory answers; there are no straightforward answers to any questions, and perhaps this is a reality always present but accentuated in the current climate of healthcare delivery. The nature of childhood as a means of conveying a distinctive ethical character and responsibility for a particular stage (or stages) of human development becomes a problematic area for contemporary bioethics to consider, and the complex developmental stages of adolescence is of peculiar interest; as such, this thesis devotes attention to the change that took place with ‘Gillick competence’. A positive assessment is made of approaching the child as person, utilising philosophers on personhood including Robert Spaemann and Alasdair MacIntyre. The vulnerability of the person, especially in the transition to adulthood, becomes a call to recognise the gift-nature of the child, and the call to solidarity with and alongside them.