Communication in healthcare is often targeted at adults and as a result minors are overlooked as information receivers of health information. Various international guidelines stress the importance of involving minors in decision-making regarding medical treatments and research participation. To this end, it is essential that minors are identified as a target group of health communication and that insight in the specifics of this target group is increased. A key issue is that no universal agreement exists about the age at which minors are competent to be involved in making medical decisions. Evidence from neuroscience research provides insights in how developing brain structures affect decision-making in minors. Neuroscience research on the developing brain in children and adolescents was reviewed and related to the capacities required for medical-decision making (communicating a choice, understanding, reasoning, appreciation). The required capacities are sufficiently developed around the age of 12. This age coincides with the onset of adolescence. In adolescence, there appears to be a mismatch between the development of two brain systems:
This mismatch affects adolescents' decision-making competence; specifically when in emotional situations the decision-making process and outcome can be severely diminished. In those contexts adolescents tend to focus on short-term outcomes, whereas medical decision-making is generally associated with long-term implications. Discussion: Developing minors become increasingly capable of understanding medical situations and decision-making, but the neurobiological developments in adolescence affect competence in specific contexts. Insights in the neuroscientific mechanisms underlying medical decision-making demonstrate strengths and vulnerabilities of minors in medical care. In addition, insight in minors as a target group can stimulate practices for optimal involvement of minors in health communication and for creating a context in which the minor can make a competent decision based on targeted information.
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