Leslie Joan Harris

Teen Health Care Decisions : How Maturity and Social Policy Affect Four Hard Cases

Abstract Legal standards that allow teens to make health care decisions, or any important decisions, must account for the contingency and variability of minors’ capacity. Traditional law denied minors’ legal authority to make any decisions, giving all power to parents. This rule goes too far; the Supreme Court has held that minors have constitutionally protected autonomy-based rights, and modern views about adolescence are inconsistent with the rule. The question is how and where to draw lines. Legal standards are based on minors’ evolving maturity, policy favoring decisions that follow medical advice, and policy supporting parental authority. This paper uses four hard cases to show how these considerations factor into legal rules.

Challenging the Overuse of Foster Care and Disrupting the Path to Delinquency and Prison

Foster care is supposed to be a temporary safe haven for abused and neglected children, a place where they are cared for while their parents solve the problems that led to their mistreatment. For many children, foster care undoubtedly serves this function well. However, thousands of children live in foster care for extended periods of time, many leaving care only when they become adults. Recent studies show that for many of these children, foster care is not a safe, nurturing place. Instead, being in care exposes these children to substantial risks of later juvenile delinquency and adult criminal arrest and conviction, as well as mental health problems, difficulties in school, poor employment prospects, poverty and homelessness. Ironically, reducing the use of foster care and focusing more on in-home services have been public policy goals in the United States for more than thirty years, and the roots of these policies go back more than a century. Despite this long consensus, the foster care system has been stubbornly resistant to change. I argue that the system persists because it allows society to assert that it is protecting children from harm while refusing to provide substantial material support to poor parents and that turning this analytical lens onto the actual functioning of the foster care system and its harmful effects on many children could provide new ways to argue for legal and policy reforms to the child welfare system that could reduce the unnecessary use of foster care and its consequences for delinquency.