Autonomy in adolescent medicine. A framework for decisions about life-sustaining treatment.

A broad consensus has been reached in the last decade about the appropriateness of decisions to withhold life-sustaining treatment from competent adult patients. The situation in adolescent medicine is not so straightforward. Legal ambiguity in determining competence and clinical difficulty in assessing decision-making capacity make such decisions in adolescent medicine problematic. A framework for making decisions about withholding or withdrawing life-sustaining therapy from adolescent patients is proposed, and cases are given to illustrate the way the framework may be applied.