Two weeks ago the UK government issued a formal apology for the thalidomide disaster. Fifty years ago, some pregnant women in the UK were given Thalidomide in order to treat morning sickness. It was effective in treating the mother's symptoms, but we soon discovered that it had horrible effects on the mothers' unborn child. About 10,000 children were harmed while in the womb, resulting in a number of children born without limbs. There are about 400 "Thalidomiders" still alive today.
This was a true tragedy, and you may think that it could not happen today. You would be very wrong. What happens today is far worse.
Thalidomide accidentally caused harm to 10,000 unborn children. However, the UK as well as the US presently approves a medication that intentionallykillsmillions of unborn children. That medication is mifiprex or RU-486. Unlike thalidomide, the only reason that mifiprex is given is to intentionally kill an unborn child. If the unborn child survives after a woman takes mifiprex, it is considered a failure of the medication.
What does it say about our culture that we issue apologies for harming children in the past at the same time we market a medication that intentionally kills children? Instead of harming children, what if thalidomide was more effective in killing them? Would we still apologize?
I've been detailing some examples of cultural cognitive dissonance during my series on the LTI podcasts. However, here's an example of significant dissonance within the largest medical association in our country. The question at hand is whether or not the adolescent brain is capable of making informed decisions that they can be responsible for.
In 2004, the AMA wrote an amicus brief in which they claimed that adolescents, even those that are 16 or 17 should not be eligible for the death penalty because their brains are not as developed as an adult's brain:
The adolescent’s mind works differently from ours. Parents know it. This Court has said it. Legislatures have presumed it for decades or more. And now, new scientific evidence sheds light on the differences.
Scientists have documented the differences along several dimensions. Adolescents as a group, even at the age of 16 or 17, are more impulsive than adults. They underestimate risks and overvalue short-term benefits. They are more susceptible to stress, more emotionally volatile, and less capable of controlling their emotions than adults.
In short, the average adolescent cannot be expected to act with the same control or foresight as a mature adult. Behavioral scientists have observed these differences for some time. Only recently, however, have studies yielded evidence of concrete differences that are anatomically based. Cutting-edge brain imaging technology reveals that regions of the adolescent brain do not reach a fully mature state until after the age of 18. These regions are precisely those associated with impulse control, regulation of emotions, risk assessment, and moral reasoning. Critical developmental changes in these regions occur only after late adolescence. (emphasis mine)
The AMA notes that parents know that adolescents do have the decision making capacity as adults do and therefore are unable to make an informed decision. For that reason, the AMA believes that a 17 year old who decides to kidnap their neighbor and brutally torture and kill them should be immune to capital punishment.
However, there is an area in which the AMA believes a 15 year old girl not only has the capacity to make an informed decision that she can take full responsibility for, but that she also has the capacity to decide when her parents need to be informed of this decision. Of course, this is in the area of abortion. Their ethics paper on the topic is from 1993, but is still the prevailing opinion in the AMA:
Physicians should not feel or be compelled to require minors to involve their parents before deciding whether to undergo an abortion. The patient, even an adolescent, generally must decide whether, on balance, parental involvement is advisable. Accordingly, minors should ultimately be allowed to decide whether parental involvement is appropriate. Physicians should explain under what circumstances (eg, life-threatening emergency) the minor’s confidentiality will need to be abrogated.
Physicians should try to ensure that minor patients have made an informed decision after giving careful consideration to the issues involved. They should encourage their minor patients to consult alternative sources if parents are not going to be involved in the abortion decision.
Let's see if I have this correct. Because of the fact that their brain is unable to process information like an adult, and that their brain physiology makes them prone to emotional decisions without the ability for critical thinking, teens should not be held responsible for capital punishment if they murder their neighbor. However, even younger teens, who find themselves in a highly emotional, crisis state of an unintended pregnancy, have the capacity to make a decision without parental involvement that can effect them for the rest of their lives. They are the ones that should make the sober decision of involving their parents in what may the one of most important decisions they will ever make, and one that many girls before them have grown to regret.
HT: I first read of the brief on capital punishment in Miriam Grossman's excellent book "You're Teaching My Child What?: A Physician Exposes the Lies of Sex Ed and How They Harm Your Child" available here.
