Virtual Mentor. November 1999, Volume 1, Number 3.

Cases in Law and Ethics

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Who Makes Contraceptive Decisions for Adolescents?

A case exploring who has the authority to make contraceptive choices, 15-year-old girl whose sexually active status is unknown or her mother, and what is the physician's duty in the situation.

Both ethics and law address norms that govern physicians’ behavior. Many view the law as a baseline for articulating the limits placed on individuals living within society as well as an enabling device to facilitate social relationships. Encompassing as the law may be in some areas of human conduct, in many others, it is silent. In the absence of legal norms or prohibitions, physicians often find guidance in the standards arrived at through ethical reasoning.

To guide students through the process of ethical reasoning and to acquaint them with case law, a new case study will appear every 2 to 4 weeks. Students will be given legal and/or ethical opinions to assist their decision-making.

November Case Scenario

During your ambulatory care rotation, you are working with an OB/GYN at her office. A mother brings in her 15-year-old daughter for a gynecological examination. The mother regrets that she was sexually active at a young age and had a child as a teenage mother. The daughter has recently started dating. The mother believes that her daughter is sexually active and wants her to be put on a regimen of Depo-Provera. The daughter denies being sexually active and refuses to be placed on Depo-Provera. The mother is very insistent and believes this is for her daughter's "own good."

1. Who has the authority to make contraceptive choices in this case, the mother or daughter?
2. What is the physician's duty? AMA Code of Medical Ethics Opinion E-5.055 on confidential care for minors may inform this case.