Abstract
An emergency team was challenged with ethical issues while managing an unmarried adolescent girl who presented with an acute abdomen wherein a ruptured ectopic pregnancy was suspected. Consent remained at the center of this dilemma given the age of the patient and the nature of the issues. Herein, we deliberate upon the challenges faced by the treating team in accessing the reproductive history, obtaining consent for performing pregnancy tests and for therapeutic interventions.
References
Joseph JT. Comprehensive sexuality education in the Indian context: Challenges and opportunities. Indian J Psychol Med. 2023;45:292–6.
World Health Organization. Adolescent Pregnancy. Accessed on Mar 24, 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
The Protection of Children From Sexual Offences Act, 2012. Accessed on Mar 24, 2024. Available from: https://www.indiacode.nic.in/bitstream/123456789/9318/1/sexualoffencea2012-32.pdf
Tunick M. State authority, parental authority, and the rights of mature minors. J Ethics. 2023;27:7–29.
Ludewigs S, Narchi J, Kiefer L, Winkler EC. Ethics of the fiduciary relationship between patient and physician: The case of informed consent. J Med Ethics. 2022;23:jme–2022108539.
Ministry of Health and Family Welfare, Government of India. Guidelines & Protocols: Medico-legal Care for Survivors/Victims of Sexual Violence. Accessed on Mar 24, 2024. Available from: https://main.mohfw.gov.in/sites/default/files/953522324.pdf
Dayal R, Gundi M. Assessment of the quality of sexual and reproductive health services delivered to adolescents at Ujala clinics: A qualitative study in Rajasthan, India. PLoS One. 2022;17:e0261757.
Kaushik JS, Narang M, Agarwal N. Informed consent in pediatric practice. Indian Pediatr. 2010;47:1039–46
Larcher V. Consent, competence, and confidentiality. BMJ 2005;330:353–6.
Ott MA. Confidentiality in primary care pediatrics. Pediatr Clin N Am 2024; 71:49–58.
Katz AL, Webb SA, AAP Committee on Bioethics. Informed Consent in Decision-Making in Pediatric Practice. Pediatrics. 2016;138:e20161485.
Reis LF, Surkan PJ, Atkins K, Garcia-Cerde R, Sanchez ZM. Risk factors for early sexual intercourse in adolescence: A systematic review of cohort studies. Child Psychiatry Hum Dev. 2023 Mar 25:1–14. Online ahead of print. Accessed on Mar 24, 2024. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039773/pdf/10578_2023_Article_1519.pdf
Sharma SK, Vishwakarma D. Transitions in adolescent boys and young men’s high-risk sexual behaviour in India. BMC Public Health. 2020;20:1089.
Ehrlich JS. From age of consent laws to the “Silver Ring Thing”: The regulation of adolescent female sexuality. Health Matrix Clevel. 2006 Winter;16:151–81.
Funding
Funding: None
Author information
Authors and Affiliations
Contributions
Contributors: SL: Conceptualized the article, drafted content for the initial manuscript, and reviewed and revised the manuscript for intellectual content; NG, BD, SR, RPM: Contributed to the content for the initial manuscript, and reviewed and revised the manuscript for intellectual content. All authors approved the final manuscript and agreed to be accountable for all aspects of the work.
Corresponding author
Ethics declarations
Competing Interests: None stated.
Additional information
Disclaimer: Opinions expressed within the content are solely the authors’ and do not reflect the opinions and beliefs of their affiliates.
Rights and permissions
About this article
Cite this article
Gupta, N., Dhingra, B., Raha, S. et al. Ethical Challenges and Guidance Related to Adolescent Pregnancy. Indian Pediatr 61, 482–485 (2024). https://doi.org/10.1007/s13312-024-3138-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13312-024-3138-8