Psychiatrists may become involved in circumstances where a child is seeking termination of pregnancy. Potential roles include capacity advice and advocacy, but ethical and legal uncertainties abound. This paper uses illustrative cases, in an Australian jurisdiction, to exemplify the issues.
Conclusion:
Termination of pregnancy at the youthful extreme raises unique challenges for all involved.
World Health Organization. Unsafe abortion: global and regional estimates of incidence of unsafe abortion and associated mortality in 2008. 6th ed.Geneva: World Health Organization, 2011, p.66.
2.
World Health Organization. Safe abortion: technical and policy guidance for health systems. 2nd ed.Geneva: World Health Organization, 2012.
3.
Australian Institute of Health and Welfare. Teenage mothers in Australia 2015. Cat. no. PER 93. Canberra: AIHW, 2018.
4.
FinerLFineJB.Abortion law around the world: progress and pushback. Am J Public Health2013; 103: 585–589.
HoggartL.‘I’m pregnant … what am I going to do? ’ An examination of value judgements and moral frameworks in teenage pregnancy decision making. Health Risk Soc2012; 14: 533–549.
7.
SkeneL.Citizen child: Australian law and children’s rights. Australian Institute of Family Studies. Melbourne: Australian Institute of Family Studies, 1996.
8.
KutherTL.Medical decision-making and minors: issues of consent and assent. Adolescence2003; 38: 343–358.
9.
BuchananA.Mental capacity, legal competence and consent to treatment. J R Soc Med2004; 97: 415–420.
10.
KrähenbühlSBladesM.The effect of interviewing techniques on young children’s responses to questions. Child Care Health Dev2006; 32: 321–331.
11.
Queensland Clinical Guidelines Queensland Government, Maternity and Neonatal Clinical Guidelines: Therapeutic termination of pregnancy. Brisbane: Queensland Health, 2018, p.30.
12.
Queensland Government and Clinical Excellence Division. Termination of pregnancy in Queensland information for health practitioners. Brisbane: Queensland Health, 2018.
13.
DouglasHde CostaCM.Time to repeal outdated abortion laws in New South Wales and Queensland. Med J Aust2016; 205: 353–354.
14.
UpadhyayUDBiggsMAFosterDG.The effect of abortion on having and achieving aspirational one-year plans. BMC Womens Health2015; 15: 102.
15.
BiggsMUpadhyayUDMcCullochCEet alWomen’s mental health and well-being 5 years after receiving or being denied an abortion: a prospective, longitudinal cohort study. JAMA Psychiatry2017; 74: 169–178.
16.
de CostaCMDouglasH. Abortion law in Australia: it’s time for national consistency and decriminalisation. Med J Aust2015; 203: 349–350.
17.
Marie Stopes International. Real choices: women, contraception and unplanned pregnancy. Melbourne: Marie Stopes International, 2008, p.15.
18.
LoaizaELiangM.Adolescent pregnancy: a review of the evidence. New York: UNFPA, 2013, p.58.
19.
FosterDGSteinbergJRRobertsSCet al. A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one. Psychol Med2015; 45: 2073-2082.