will explore. Parents are generally deemed to be the appropriate medical decision makers for their minor children, although some state statutes specifically authorize adolescent consent to substance abuse treatment with or without parental concurrence.6 Administering immunotherapy to a nonconsenting adolescent pits the autonomy interest of the minor against the parent’s countervailing determination of that child’s best interests. The reverse legal dilemma can also occur, as when a minor seeks therapy—such as birth control—but the adolescent does not want to inform the parent about his or her sexual activity or when the parent refuses to authorize the treatment.7

Whose interests will prevail in parent-child disagreements about undergoing immunotherapy cannot be predicted with certainty for, as with virtually all legal questions, the answer depends on the underlying facts of the particular situation. How old is the child? What has been the history of the parent-child or other relevant authority figure relationship? How imminent is the threatened harm? How well established is the proposed therapy? How invasive is it? How permanent are the effects of treatment and of nontreatment? All of these factors must be weighed in determining whether a parent or other party in loco parentis has legal authority to make decisions about immunotherapy “for” an individual child or whether indeed that child might have the legal capacity to make such decisions on his or her own.

Generally speaking, the younger the child, the more imminent the threatened harm, and the more short lived the effects of the vaccine, the more likely the courts will uphold parental choices about administering immunotherapy to their offspring, notwithstanding a child’s lack of specific assent. Conversely, the older the adolescent, the more remote the perceived harm, and the longer lasting the effects of the treatment, the more likely it is that courts will give weight to a minor’s refusal to assent to immunotherapy in the face of parental pressure to undergo it.

Types of Immunotherapy

At first glance, drug addiction vaccines seem promising and attractive for short-circuiting addictions in minors before they get the chance to take hold. The addictive nature of potentially harmful—if not deadly—substances diminishes significantly after this kind of immunotherapy takes effect. Addiction immunotherapies reduce chemical dependency on addictive substances and can be administered in two different ways: as either active or passive immunotherapy.

6  

See statutes cited in Hartman (2002).

7  

Id. at note 38. See also Newcomer and Udry (1985).



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