She also wonders whether Adam, who clearly is interested in his future with respect to being a father, has a right to know about this side effect. We must respect their wishes.” Jenny wonders whether Adam could suffer psychologically if he survives his cancer and later realizes he was uninformed about the treatment’s infertility risk. K says, “His parents understand that Adam needs to be treated immediately and they’ve clearly stated that they don’t want him to know about the infertility risk. K about whether to inform Adam about the virtual certainty of his infertility due to the chemotherapy he needs. They also discuss Adam’s anger, which often stems from his feeling a lack of control over his life, commonly seen in adolescents with cancer.

K, and he and Jenny discuss Adam’s future views about family at length with no mention of the infertility risk posed by Adam’s treatment. Adam’s father states, “He’s too young to understand.” Later, Jenny is talking with Adam about his hobbies and aspirations and Adam says, “I can’t wait to have a big family one day.” Jenny relates this to Dr. K not mention the possibility of infertility to Adam. Adam’s parents say that they are not interested in sperm banking and request that Dr. K also explains to Adam’s parents that Adam will likely be infertile after treatment and that he might not have time to bank sperm. K, explains to Adam and his parents that the treatment has a very high cure rate and should be started immediately. Jenny is a medical student following the care of Adam, a 13-year-old boy who has just been diagnosed with Ewing’s sarcoma of the left distal femur. I consider whether minors, particularly older ones, have a right to know that supersedes their parents’ wishes. The case presented here poses special problems because of the parents’ desire to shield their child from certain information deemed important by his physicians. Minors present a unique challenge, as their ability to understand and process information usually increases with age. For patients who lack the cognitive capacity to do so because of either inborn or acquired deficits or because of youth, the extent to which they can participate in medical decisions is variable. In Western medicine, a central component of respecting a person’s ability to make decisions governing what happens to herself is ensuring that she is provided with sufficient relevant information to make a rational choice.

I have used all my patients on my kids