This article analyzes the migration experiences of thirteen separated minors who arrived in Sweden between 1943 and 2008. Using the framework of "dislocation" and the "liberated self," this chapter shows that the experiences of separated minors are shaped in the intersection between contexts and conditions of transnational migration and the Swedish reception system. Their efforts to continue living based on the past and building a new life during a period of transition between different countries and between childhood and adulthood can be described as "a life on hold." The paradox that migration serves simultaneously to empower and render children powerless is discussed.
The principles of the right to informed consent and informed refusal are quite clear for competent adult patients. The right of a competent adult patient to give his informed consent before medical treatment can be started, is a patients' right that is recognised all over the world. The logical corollary of the right to informed consent is the right to informed refusal. A competent adult patient also has the right to refuse medical treatment by simply withholding or withdrawing his consent. A physician who starts medical treatment without the informed consent of his patient will be held liable for battery. Can these same principles be applied to minors? In other words: do minors also have the right to refuse medical treatment? Can a minor refuse even life preserving care? The interests of the involved parties (minor, parents and state) have to be weighed against each other case by case. A thorough examination of the available case law shows that the best interests of the minor are paramount. This "best interests" standard guides judges in their making of a decision. However, this is certainly not always in accordance with reality. In fact, minors can be mature enough to refuse treatment at a much earlier time than the age of legal majority, whatever the consequences of that refusal may be.
The critical need for pediatric research on drugs and biological products underscores the responsibility to ensure that children are enrolled in clinical research that is both scientifically necessary and ethically sound. In this chapter, we review key ethical considerations concerning the participation of children in clinical research. We propose a basic ethical framework to guide pediatric research, and suggest how this framework might be operationalized in linking science and ethics. Topics examined include: the status of children as a vulnerable population; the appropriate balance of risk and potential benefit in research; ethical considerations underlying study design, including clinical equipoise, placebo controls, and non-inferiority designs; the use of data monitoring committees; compensation; and parental permission and child assent to participate in research. We incorporate selected national (USA) and international guidelines, as well as regulatory approaches to pediatric studies that have been adopted in the USA, Canada, and Europe.
To examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications.
This was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival.
Initially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway.
Male UM from Afghanistan, Somalia, Algeria and Iran.
Mental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire.
At the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress.
Mental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum.
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The ethical and legal obligations with respect to treating a minor can be confusing, particularly in the areas of consent to treatment, confidentiality, and parental involvement. The clinician must be aware of the appropriate course of practice when the patient is an adolescent seeking care for contraception, pregnancy, or sexually transmitted infections. This article examines a number of ethical and legal issues that arise when providing reproductive and sexual health care to an adolescent and offers recommendations for the physician's most appropriate courses of action regarding adolescent patients and the age of consent to sexual activity, reporting of child abuse, provision of reproductive and sexual health care to a minor, assessing an adolescent's capacity to consent to treatment, the physician's duty of confidentiality, and the exceptions to the rule of confidentiality.
This article concerns the legal regulation of medical research on children in Finland. The topic is covered by the Medical Research Act of 1999 and by the Recommendations issued by the Working group on medical research on children in 2003. The Decisions of the Parliamentary Ombudsman also play an important role in this area in Finland. The article focuses on two specific issues: involvement of guardians in decision-making for the child, and the expansion of the right to self-determination of minors. Two case examples on these topics are also discussed. Overall, the author comes to the conclusion that the Finnish legislation, policy-makers, investigators and the industry have succeeded well in taking into account international legislation in this area, although there is also room for improvement.
The "gay propaganda law"-criminalizing public messaging supporting sexual and gender minority (SGM) communities in the presence of youth-implemented within Russia in 2013 has been widely criticized by those in the international field of human rights, yet remains in effect. Although the law is supposedly protecting the well-being of children, it is likely detrimental to youth who may be sexual or gender minorities. This paper uses the 2018 conviction of a minor for violating this law to frame a discussion concerning how Russia, rather than progressively respecting, protecting, and fulfilling the rights of its people, is rejecting, regressing, and neglecting its rights obligations. In particular, we consider the rights outlined in the Convention on the Rights of the Child and the International Covenant on Civil and Political Rights to determine ways in which the Russian state could redirect its actions to support human rights for SGM people and their allies.