I wish to acknowledge with gratitude the Committee on Health, Education, Labor and Pensions of the U.S. Senate for amenability to formulating national policy related to adolescence and devising The Younger Americans Act. I am equally grateful for the ever-gracious support provided by the American Journal of Law & Medicine.

1 In re Gault, 387 U.S. 1 (1967); Kent v. United States, 383 U.S. 541 (1966).

2 While the Supreme Court has extended constitutional guarantees to adolescents, including privacy interests, expressive choice and liberty rights, the Court has observed that immaturity and inexperience limit legal autonomy for decision-making because adolescents lack the capable judgment “for making life's difficult decisions.” Troxel v. Granville, 530 U.S. 57, 68 (2000) (quoting Parham v. J.R., 442 U.S. 584, 602 (1979)); see also Bd. of Educ. v. Earls, 122 S. Ct. 2559 (2002); Tinker v. Des Moines, 393 U.S. 503 (1969); In re Gault, 387 U.S. 1 (1967).

3 Parham, 442 U.S. at 602 (1979); Ginsberg v. New York, 390 U.S. 629, 638 (1968); Prince v. Massachusetts, 321 U.S. 158, 168 (1944).

4 See generally Bellotti v. Baird, 443 U.S. 622 (1979) (discussing the constitutionality of statutes that require minors to obtain parental consent for abortions).

5 Parham v. J.R., 442 U.S. at 605. See Perry, Gail S. & Melton, Gary B., Precedential Value of Judicial Notice of Social Facts: Parham as an Example, 22 J. FAM. L. 633 (1983-1984)Google Scholar (exposing factual assumptions and empirical speculations throughout the Supreme Court's decision in Parham); Hartman, Rhonda Gay, Adolescent Autonomy: Clarifying an Ageless Conundrum, 51 HASTINGS L.J. 1265, 1333-34 (2002)Google Scholar (advocating revisitation by the Supreme Court of the issue presented in Parham v. J.R.).

6 Parham, 442 U.S at 605; see also Troxel v. Granville, 530 U.S. at 68.

7 Scott, Elizabeth S., The Legal Construction of Adolescence, 20 HOFSTRA L. REV. 547, 548 (2000)Google Scholar (stating that policy-makers “ignore this transitional developmental stage, classifying adolescents legally as children or adults, depending on the issue at hand”).

8 See Stanford v. Kentucky, 492 U.S. 361, 380 (1989) (finding that state statutes authorizing the death sentence for adolescents who were sixteen or seventeen years old at the commission of a capital offense do not offend the Eighth Amendment of the Constitution); see also Patterson v. Texas, 153 L.Ed. 2d 887 (2002) (denying an execution stay for Toronto Patterson who was sentenced to death for the conviction of a capital crime he committed when he was seventeen years old). Justice Stevens disagreed with the majority's denial and urged the Supreme Court to “revisit the issue at the earliest opportunity.” Patterson, 153 L.Ed. 2d at 887 (Stevens, J., dissenting). Justice Ginsberg joined Justice Stevens's dissent and implied that reconsideration might be appropriate in light of recent case law. Patterson, 153 L.Ed. 2d at 887 (Ginsberg, J., dissenting). See Hartman, supra note 5, at 1295 (advocating reconsideration by the U.S. Supreme Court of the issue due to legal policy rife with inconsistency).

9 Several states permit only “competent adult[s]” or persons “eighteen years or older” to make legally valid advance directives, such as the execution of a living will that authorizes the termination of life-sustaining treatment. See ALA. CODE § 22-8A-4 (Supp. 2001) (“competent adult”); GA. CODE ANN. § 31-32-3(a) (2001) (“competent adult”); W. VA. CODE § 16-30-4(a) (2001) (“competent adult”); N.D. CENT. CODE § 23-06.4-03 (2002) (“eighteen years or older”); N.H. REV. STAT. ANN. § 137-H:3 (1996) (“eighteen years or older”).

10 See generally TOM L. BEAUCHAMP & JAMES F. CHILDRESS, PRINCIPLES OF BIOMEDICAL ETHICS (5th ed. 2001); TIMOTHY E. QUILL, A MIDWIFE THROUGH A DYING PROCESS (1996); JAY KATZ, THE SILENT WORLD OF DOCTOR AND PATIENT (1984).

11 See Scott, supra note 7, at 556.

12 Wisconsin v. Yoder, 406 U.S. 205, 243 (1972) (Douglas, J., dissenting in part).

13 See, e.g., Ambuel, Bruce & Rappaport, Julian, Developmental Trends in Adolescents’ Psychological and Legal Competence to Consent to Abortion, 16 LAW & HUMAN BEHAV. 129 (1992)CrossRefGoogle Scholar; Dolgin, Michael J. et al., Caregivers’ Perceptions of Medical Compliance in Adolescents with Cancer, 7 J. ADOLESCENT HEALTH CARE 22 (1986)CrossRefGoogle ScholarPubMed; Felner, Robert D. et al., Party Status of Children During Marital Dissolution: Child Preferences and Legal Representation in Custody Disputes, 14 J. CLINICAL CHILD PSYCHOL. 42 (1985)CrossRefGoogle Scholar; Fried, Carrie S. & Reppucci, N. Dickon, Criminal Decision Making: The Development of Adolescent Judgment, Criminal Responsibility, and Culpability, 25 LAW & HUMAN BEHAV. 45 (2001)CrossRefGoogle ScholarPubMed; Ginsburg, Kenneth R. et al., Factors Affecting the Decision to Seek Health Care: The Voice of Adolescents, 100 PEDIATRICS 922 (1997)CrossRefGoogle ScholarPubMed; Ginsburg, Kenneth R. et al., Adolescents’ Perceptions of Factors Affecting Their Decisions to Seek Health Care, 273 JAMA 1913 (1995)CrossRefGoogle ScholarPubMed; Garrison, Ellen Greenberg, Children's Competency to Participate in Divorce Custody Decisionmaking, 20 J. CLINICAL CHILD PSYCHOL. 78 (1991)CrossRefGoogle Scholar; Grisso, Thomas, Juveniles’ Capacities to Waive Miranda Rights: An Empirical Analysis, 68 CAL. LAW REV. 1134 (1980)CrossRefGoogle Scholar; Hartman, Rhonda Gay, Adolescent Decisional Autonomy for Medical Care: Physician Perceptions and Practices, 8 U. CHI. L. SCH. ROUNDTABLE 87 (2001)Google Scholar; Kaser-Boyd, Nancy et al., Minors’ Ability to Identify Risks and Benefits of Therapy, 16 PROF. PSYCHOL. RES. & PRAC. 411 (1985)CrossRefGoogle ScholarPubMed; Lewis, Catherine C., A Comparison of Minors’ and Adults’ Pregnancy Decisions, 50 AM. J. ORTHOPSYCHIATRY 446 (1980)CrossRefGoogle ScholarPubMed; Maggiolini, Alfio, Self-Image of Adolescent Survivors of Long-term Childhood Leukemia, 22 J. PEDIATRIC HEMATOLOGY/ONCOLOGY 417 (September/October 2000)CrossRefGoogle ScholarPubMed; Quadrel, Marilyn Jacobs et al., Adolescent (In)Vulnerability, 48 AM. PSYCHOLOGIST 102 (1993)CrossRefGoogle Scholar; Scherer, David G., The Capacities of Minors to Exercise Voluntariness in Medical Treatment Decisions, 15 LAW & HUMAN BEHAV. 431 (1991)CrossRefGoogle ScholarPubMed; Scherer, David G. & Reppucci, N. Dickon, Adolescents’ Capacities to Provide Voluntary Informed Consent: The Effects of Parental Influence and Medical Dilemmas, 12 LAW & HUMAN BEHAV. 123 (1988)CrossRefGoogle ScholarPubMed; Trad, Paul V., The Ability of Adolescents to Predict Future Outcome Part I: Assessing Predictive Abilities, 28 ADOLESCENCE 533 (1993)Google ScholarPubMed; Weithorn, Lois A. & Campbell, Susan B., The Competency of Children and Adolescents to Make Informed Treatment Decisions, 53 CHILD DEV. 1589 (1982)CrossRefGoogle ScholarPubMed.

14 See Holmes, Oliver Wendell Jr., THE COMMON LAW 35 (Boston, Little, Brown & Co. 1881)Google Scholar (explaining that “precedents survive in the law long after the use they once served is at an end and the reason for them has been forgotten. The result of following them must often be failure and confusion from the merely logical point of view.”); see also Popper, Karl R., IN SEARCH OF A BETTER WORLD: LECTURES AND ESSAYS FROM THIRTY YEARS 37 (Bennett, Laura J. trans., Routledge 1992)Google Scholar (exhorting the uncertainties of knowledge and emphasizing its evolving nature).

15 See infra notes 38-92 and accompanying text. The Supreme Court has pinpointed legislation as “the clearest and most reliable objective evidence of contemporary values.” Harmelin v. Michigan, 501 U.S. 957, 1000 (1991). The Court emphasized that the significance of the legislative evidence is not so much in the number of enacted state statutes but in “the consistency of the direction of change.” Atkins v. Virginia, 122 S. Ct. 2242, 2249 (2002). The Court's ascription of primacy to legislative enactments “follows from the constitutional role legislatures place in expressing policy of a State.” Id. at 2253 (Rehnquist, C.J., dissenting). According to Justice Scalia, the Court must grant legislative enactments such weight “because it ‘will rarely if ever be the case that the Supreme Court will have a better sense of the evolution in views of the American people than do their elected representatives.’” Id. at 2261 (Scalia, J., dissenting) (quoting Thompson v. Oklahoma, 487 U.S. 815, 865 (1988) (Scalia, J., dissenting)).

16 In re Gault, 387 U.S. 1, 13 (1967).

17 For example, when deciding that seventeen-year-old Alexis Demos should have the opportunity to explain her medical choices to the court, rather than through representation by counsel or by parents, the Massachusetts Court of Appeals held that the power of parens patriae is strong only when the minor is immature and thus lacks the capacity to make medical decisions on her own. In re Rena, 705 N.E.2d 1155, 1157-58 (Mass. App. Ct. 1999).

18 See Craig v. Boren, 429 U.S. 190, 204 (1976) (conceding that expecting judges or legislators to be “well versed in the rigors of experimental or statistical technique” is unrealistic). Accord Daubert v. Merrell Dow Pharm., Inc., 509 U.S. 579 (1993).

19 See Am. Acad. of Pediatrics v. Lungren, 940 P.2d 797 (Cal. 1997) (finding no evidentiary justification for distinguishing adolescent from adult privacy rights based on scientific data, and interpreting affirmative grants of rights emanating from state constitutions as guaranteeing adolescents’ ability to make decisions about pregnancy termination independent of parental consent or judicial oversight); see also Britner, Preston A. et al., Evaluating Juveniles’ Competence to Make Abortion Decisions: How Social Science Can Inform the Law, 5 U. CHI. L. SCH. ROUNDTABLE 35 (1998)Google Scholar. Analyses in cases of “first impression” likewise engage scientific study and social science evidence. Grimes v. Kennedy Krieger Inst. Inc., 782 A.2d 807 (Md. 2001) (examining issues attendant to regulatory policy governing non-therapeutic pediatric research).

20 Elliott, E. Donald, The Evolutionary Tradition in Jurisprudence, 85 COLUM. L. REV. 38, 38 (1985)CrossRefGoogle Scholar (“Law is a scavenger. It grows by feeding on ideas from outside, not by inventing new ones of its own.”).

21 Redding, Richard E., Reconstructing Science Through Law, 23 S. ILL. U. L.J. 585, 585 (1999)Google Scholar (“Law is an empty vessel, relying on other disciplines to fill it with substantive knowledge.”).

22 Popper, supra note 14, at 91; see also Karl R. Popper, Campbell on the Evolutionary Theory of Knowledge, in EVOLUTIONARY EPISTEMOLOGY, RATIONALITY, AND THE SOCIOLOGY OF KNOWLEDGE 116 (Gerald Ratnitzky & W.W. Bartley III eds., 1987) (“[A]ll human knowledge is fallible and conjectural. It is a product of the method of trial and error.”).

23 See, e.g., Cotter, Thomas F., Legal Pragmatism and the Law and Economics Movement, 84 GEO. L.J. 2071 (1996)Google Scholar; Nussbaum, Martha C., The Future of Law and Economics, 64 U. CHI. L. REV. 1197 (1997)CrossRefGoogle Scholar; Posner, Richard A., Rational Choice, Behavior Economics, and the Law, 50 STAN. L. REV. 1551 (1998)CrossRefGoogle Scholar; Schroeder, Jeanne L., The End of the Market: A Psychoanalysis of Law and Economics, 112 HARV. L. REV. 483 (1998)CrossRefGoogle Scholar; Wienerkatz, Avery, Positivism and the Separation of Law and Economics, 94 MICH. L. REV. 2229 (1996)Google Scholar.

24 See, e.g., Sullivan, Lawrence A. & Fikentscher, Wolfgang, On the Growth of the Antitrust Idea, 16 BERKELEY J. INT’L L. 197 (1998)Google Scholar.

25 Gary Edmond & David Mercer, Trashing “Junk Science”, 1998 STAN. TECH. L. REV. 3; Taslitz, Andrew E., Interpretive Method and the Federal Rules of Evidence: A Call for a Politically Realistic Hermeneutics, 32 HARV. J. ON LEGIS. 329 (1995)Google Scholar; Faigman, David L., The Evidentiary Status of Social Science Under Daubert: Is it “Scientific,” “Technical,” or “Other Knowledge”, 1 PSYCHOL. PUB. POL’Y L. 960 (1995)Google Scholar. See Daubert v. Merrell Dow Pharm., Inc., 509 U.S. 579, 579 (1993) (recognizing that in toxic tort litigation, the Supreme Court can relevantly gauge the admissibility of scientific evidence under Federal Rule of Evidence 702).

26 Beecher-Monas, Erica, The Heuristics of Intellectual Due Process: A Primer for Triers of Science, 75 N.Y.U. L. REV. 1563 (2000)Google Scholar.

27 For example, a prominent method that has influenced formulation of legal policy is evolutionary epistemology. Evolutionary epistemology, as conceived by Sir Karl Raimond Popper, envisages a multi-stage knowledge acquisition apparatus, consisting of problem identification, assertion advancement, examination and refutation of assertions, and ongoing exploration of ideas that withstand examination and refutation. See POPPER, supra note 14; see also KARL R. POPPER, CONJECTURES AND REFUTATIONS: THE GROWTH OF SCIENTIFIC KNOWLEDGE 27-29 (Routledge & Kegan Paul Limited 2nd ed. 1965). According to Popper, simplicity and clarity are indispensable to the quality of examination and falsification; otherwise, exposure of inconsistencies and fallacies of assertions are inhibited. See POPPER, supra note 14, at 91-92.

28 Scherer, supra note 13, at 444-46; Scherer & Reppucci, supra note 13, at 135.

29 Gardner, William et al., Asserting Scientific Authority: Cognitive Development and Adolescent Legal Rights, 44 AM. PSYCHOLOGIST 895, 896 (1989)CrossRefGoogle ScholarPubMed.

30 Saks, Michael J., Legal Policy Analysis and Evaluation, 44 AM. PSYCHOLOGIST 1110, 1110 (1989)CrossRefGoogle Scholar.

31 Quadrel et al., supra note 13, at 111.

32 See POPPER, supra note 27, at 27.

33 See Hartman, supra note 13, at 87-88 (stating that “[d]ecisional autonomy is an elusive concept … . Despite descriptive terms for decisional capacity that seem as varied as a standard by which to measure it, debates about how it should be measured and in what ways each of us diverge from the standard remain unresolved”(footnote omitted)).

34 In re Rena, 705 N.E.2d 1155 (Mass. App. Ct. 1999) (recognizing the capability of an adolescent to refuse a blood transfusion due to her spiritual faith as a Jehovah's Witness); In re E.G., 549 N.E.2d 322 (Ill. 1989) (finding that the mature minor doctrine was sufficient grounds for the trial court to hold a minor capable of refusing medical treatment); In re Green, 307 A.2d 279 (Pa. 1973) (affirming the trial court's order that respected the wishes of an adolescent to decline a spinal operation stemming from his faith as a Jehovah's Witness). But see In re J.J., 582 N.E.2d 1138 (Ohio Ct. App. 1990) (ordering gonorrhea treatment for an adolescent despite his refusal of treatment based on a belief in faith healing).

35 Cardwell v. Bechtol, 724 S.W.2d 739 (Tenn. 1987).

36 See Cruzan v. Dir., Mo. Dep’t. of Health, 497 U.S. 261 (1990).

37 Id. at 261 n.7.

38 ALA. CODE § 22-11A-19 (1997); ALASKA STAT. § 25.20.025(A)(4) (Michie 2001); ARIZ. REV. STAT. ANN. § 44-132.01 (West 1994); ARK. CODE ANN. § 20-16-508 (Michie 2000); CAL. FAM. CODE § 6926 (West 1994); COLO. REV. STAT. § 25-4-402(4) (2001); CONN. GEN. STAT. ANN. § 19A- 216(a) (West 1998); DEL. CODE ANN. tit. 13, § 710 (1999); FLA. STAT. ANN. § 384.30 (West 2002); GA. CODE ANN. § 31-17-7(a) (2001); HAW. REV. STAT. ANN. § 577A-2 (Michie 1999); IDAHO CODE § 39-3801 (Michie 2002); 410 ILL. COMP. STAT. ANN. 210/4 (West 1997); KY. REV. STAT. ANN. § 214.185(1) (Michie 1998); LA. REV. STAT. ANN. § 40:1065.1(A) (West 2000); ME. REV. STAT. ANN. tit. 22, § 1823 (West 1992 & Supp. 2001); MD. CODE ANN., HEALTH-GEN. § 20-102c(3) (2000); MICH. COMP. LAWS ANN. § 333.5127 (West 2001); MINN. STAT. ANN. § 144.343 (West 1998); MISS. CODE ANN. § 41-41-13 (1999); MO. ANN. STAT. § 431.061 (West 2002); MONT. CODE ANN. § 41-1-4- 2(1)(c) (2001); N.J. STAT. ANN. § 9:17A-4 (West 1993); OHIO REV. CODE ANN. § 3709.241 (Anderson 2002); OKLA. STAT. ANN. tit. 63, § 1-532.1 (West 1997); OR. REV. STAT. § 109.610 (2001); PA. STAT. ANN. tit. 35 § 521.14a (West 1993); S.D. CODIFIED LAWS § 34-23-16 (Michie 1994); UTAH CODE ANN. § 26-6-18 (1998); VT. STAT. ANN. tit. 18 § 4226 (1982); VA. CODE ANN. § 54.1-2969(E)(1) (LexisNexis 2002); W. VA. CODE ANN. § 16-4-10 (Michie 2001).

39 MICH. COMP. LAWS ANN. § 333.5127 (West 2001).

40 For a case description of this genre and the policy and practical questions presented, see Hartman, supra note 13, at 92; see also Hartman, supra note 5, at 1310.

41 E.g., ALA. CODE § 22-11A-19 (1997) (twelve years or older); CAL. FAM. CODE § 6926 (West 1994) (twelve years or older); IDAHO CODE § 39-3801 (Michie 2002) (fourteen years or older); VT. STAT. ANN. tit. 18, § 4226 (1983) (twelve years or older); WASH. REV. CODE ANN. § 70.24.110 (West 2002) (fourteen years or older).

42 See, e.g., ALA. CODE § 22-8-6 (1997); ARIZ. REV. STAT. ANN. § 44-133.01 (West 1994); CAL. FAM. CODE § 6929(b) (West 1994); COLO. REV. STAT. § 13-22-102 (2001); CONN. GEN. STAT. ANN. § 17A-688 (West 1998 & Supp. 2002); FLA. STAT. ANN. § 397.601(4)(a) (West 2002); GA. CODE ANN. § 31-17-7(b) (2001); HAW. REV. STAT. ANN. § 577-26 (Michie 1999); 410 ILL. COMP. STAT. ANN. 210/4 (West 1997); IND. CODE ANN. § 12-23-12-1 (West 2002); KAN. STAT. ANN. § 65- 2892a (1992); KY. REV. STAT. ANN. § 222.441 (Michie 1998); LA. REV. STAT. ANN. § 40:1096A (West 2000); ME. REV. STAT. ANN. tit. 22, § 1502 (West 1992 & Supp. 2001); MD. CODE ANN., HEALTH-GEN. § 20-102(c)(1)-(2) (2000); MASS. GEN. LAWS ANN. ch 112, § 12E (2000); MICH. COMP. LAWS ANN. § 333.6121(1) (West 2001); MINN. STAT. ANN. § 144.343(1) (West 1998); MISS. CODE ANN. § 41-41-14 (1999); NEB. REV. STAT. § 71-5041 (1996); NEV. REV. STAT. 129.050 (2001); N.J. STAT. ANN. § 9:17A-4 (West 1993); OHIO REV. CODE ANN. § 3719.012 (Anderson 2002); OKLA. STAT. ANN. tit. 43A, § 9-101 (West 1997); PA. STAT. ANN. tit. 71, § 1690.112 (West 1993); VT. STAT. ANN. tit. 18, § 4226 (1982); VA. CODE ANN. § 54.1-2969(E)(3) (Michie 2002); W.VA. CODE ANN. § 60A-5-504 (e) (Michie 2001); Wis. Stat. Ann. § 51.47 (West 1997).

43 See, e.g., ALA. CODE § 22-8-6 (1997); 410 ILL. COMP. STAT. ANN. 210/4 (West 1997); KY. REV. STAT. ANN. § 214.185(1) (Michie 1998).

44 See ARIZ. REV. STAT. ANN. § 44-133.01 (West 1994) (twelve years or older); CAL. FAM. CODE § 6929(b) (West 1994) (twelve years or older); 410 ILL. COMP. STAT. ANN. 210/4 (West 1997) (twelve years or older); MASS. GEN. LAWS ch. 112, § 12E (2000) (twelve years or older); MISS. CODE ANN. § 41-41-14 (1999) (fifteen years or older); 18 VT. STAT. ANN. tit. 18, § 4226 (2001) (twelve years or older); WIS. STAT. § 51.47 (2001) (twelve years or older).

45 GA. CODE ANN. § 31-7-8 (2001).

46 MICH. COMP. LAWS ANN. § 333.6121 (West 2001); LA. REV. STAT. ANN. § 40:1096 (West 2000).

47 COLO. REV. STAT. § 13-22-102 (2001).

48 MASS. GEN. LAWS ch. 112, § 12E (2000).

49 410 ILL. COMP. STAT. ANN. 210/3 (West 1997 & Supp. 2002).

50 PA. STAT. ANN. tit. 71, § 1690.112 (West 1993).

51 OKLA. STAT. ANN. tit. 63, § 2602(A)(3) (West 1997).

52 MICH. COMP. LAWS ANN. § 333.5127(2) (West 2001). Several states have similar legislation that enables medical staff to disclose a minor's confidential medical information to a spouse, parents, custodians or guardians. See DEL. CODE ANN. tit. 13, § 710(c) (1999); GA. CODE ANN. § 31-17-7(b) (2001); MISS. CODE ANN. § 41-41-14 (1999).

53 CAL. FAM. CODE § 6929(c) (West 1994); see also 410 ILL. COMP. STAT. ANN. 210/4 (West 1997) (requiring expenditure of “reasonable efforts” by a physician to involve family and assist a minor in accepting involvement); NEV. REV. STAT. 129.050(3) (2001) (requiring reasonable efforts to report treatment to parents or guardians “within a reasonable time after treatment”); VT. STAT. ANN. tit. 18, § 4226 (2001) (mandating parent or guardian notification “if the condition of a minor child requires immediate hospitalization”); WIS. STAT. § 51.47(3) (2001) (mandating parental notification “as soon as practicable”).

54 CAL. FAM. CODE § 6929(g) (West 1994); see id. § 7050(e)(1) (declaring that an emancipated minor shall be considered an adult for the purpose of consenting to medical care); see also HAW. REV. STAT. § 577A-4 (Michie 1999) (promoting a policy of “open[ing] up lines of communication between parent and child”).

55 410 ILL. COMP. STAT. ANN. 210/4 (West 1997); NEV. REV. STAT. 129.050(3) (2001).

56 ALA. CODE § 22-8-6 (1997); ALASKA STAT. § 25.20.025(a)(4) (Michie 2001); CAL. FAM. CODE § 6925(a) (West 1994); DEL. CODE ANN. tit 13, § 710 (1999); FLA. STAT. ANN. § 743.065(1) (West 2002); HAW. REV. STAT. ANN. § 577A-4 (Michie 1999); KAN. STAT. ANN. § 38-123 (1992); KY. REV. STAT. ANN. § 214.185 (Michie 1998); MD. CODE ANN., HEALTH-GEN. § 20-102(c)(4) (2000); MASS. GEN. LAWS ch. 112, § 12F (2000); MINN. STAT. ANN. § 144.343 (West 1998); MO. ANN. STAT. § 431.061 (West 2002); MONT. CODE ANN. § 41-1-402(1)(c) (2001); OKLA. STAT. tit. 63, § 2602(3) (West 1997); 35 PA. CONS. STAT. § 10103 (2002); VA. CODE ANN. § 54.1-2969(e)(2) (2002).

57 See MD. CODE ANN., HEALTH-GEN. § 20-102(c)(5) (2000); VA. CODE ANN. § 54.1- 2969(E)(2) (2002). But see NEV. REV. STAT. 430A.180 (2001) (disallowing administration of contraceptives to minors unless a parent or guardian grants consent). The Court of Appeals for the Third Circuit, however, interpreted federal law to extend confidentiality to minors’ consent for reproductive services, thereby superceding state parental consent requirements. Parents United for Better Schools, Inc. v. Sch. Dist. of Phila. Bd. of Educ., 148 F.3d 260, 269-70 (3d Cir. 1998).

58 MD. CODE ANN., HEALTH-GEN. § 20-102(c)(5) (2000); MASS. GEN. LAWS ch. 112, § 12F (2000); VA. CODE ANN. § 54.1-2969(E)(2) (2002).

59 FLA. STAT. ANN. § 743.065 (West 2002); KAN. STAT. ANN. § 38-123 (1992).

60 CAL. CIV. PROC. CODE § 1295 (2001).

61 DEL. CODE ANN. tit. 13, § 710(b) (1999); HAW. REV. STAT. ANN. § 577A-2 (Michie 1999). See JOHN EDWARD MURRAY, JR., MURRAY ON CONTRACTS 40 (3d. ed. 1990). For commentary and critique of the power of minors to disaffirm and discharge their contractual obligations, see Hartman, supra note 5, at 1301-05; DiMatteo, Larry A., Deconstructing the Myth of the ‘Infancy Law Doctrine’: From Incapacity to Accountability, 21 OHIO N.U.L. REV. 481 (1994)Google Scholar; Edge, Robert E., Voidability of Minors Contracts: A Feudal Doctrine in a Modern Economy, 1 GA. L. REV. 205 (1967)Google Scholar.

62 See, e.g., COLO. REV. STAT. § 13-22-106 (2001); 410 ILL. COMP. STAT. ANN. 210/3 (West 1997); ME. REV. STAT. ANN. tit. 22, § 1823 (West 1992 & Supp. 2001); MD. CODE ANN., HEALTHGEN. § 20-102(c)(6)-(7) (2000); OHIO REV. CODE ANN. § 2907.29 (Anderson 2000); see also N.J. STAT. ANN. § 9:17A-4 (West 1993) (requiring immediate notification of parents).

63 ARIZ. REV. STAT. ANN. § 13-1413 (West 1994).

64 CAL. FAM. CODE §§ 6927, 6928 (West 1994).

65 410 ILL. COMP. STAT. ANN. 210/3 (West 1997); TEX. FAM. CODE ANN. § 32.004 (2002).

66 ALA. CODE § 22-8-4 (1997) (fourteen years or older); CAL. FAM. CODE § 6924(b) (West 1994) (twelve years or older); COLO. REV. STAT. § 13-22-103(1) (2001) (fifteen years or older if living apart from parent or guardian); FLA. STAT. ANN. § 394.4784(1)-(2) (West 2002) (thirteen years or older); KY. REV. STAT. ANN. § 214.185(2) (Michie 1998) (sixteen years or older); MICH. COMP. LAWS ANN. § 330.1707(1) (West 2001) (fourteen years or older); MISS. CODE ANN. § 41-41-14(1) (1999) (fifteen years or older); MONT. CODE ANN. § 53-21-112(2) (2001) (sixteen years or older); OHIO REV. CODE ANN. § 5122.04 (Anderson 2000) (fourteen years or older); OR. REV. STAT. § 109.675 (2001) (fourteen years or older); VA. CODE ANN. § 54.1-2969E(4) (Michie 2001) (fourteen years or older); WASH. REV. CODE ANN. § 71.34.042 (West 2002) (thirteen years or older); WIS. STAT. § 51.14 (2001) (fourteen years or older).

67 DEL. CODE ANN. tit. 16, § 5161 (1999); WIS. STAT. § 51.13(2)(a) (2001). See Parham v. J.R., 442 U.S. 584 (1979) (relying on the Due Process Clause to uphold the constitutionality of a state involuntary commitment procedure requiring parent consent coupled with psychiatric evaluation).

68 PA. STAT. ANN. tit. 50, § 7201 (West 1993); see also COLO. REV. STAT. § 13-22-101 (2001) (stating that a minor fifteen years or older may consent to receipt of mental health services); FLA. STAT. ANN. § 394.4784 (West 2002) (stating that a minor thirteen years or older has the right to request professional assistance after experiencing an emotional crisis to such a degree that he or she perceives the need for professional assistance); MONT. CODE ANN. § 53-21-112 (2001) (stating that a minor sixteen years or older may consent to receipt of mental health services); WIS. STAT. § 51.14 (2001) (a minor fourteen years or older may consent to receipt of mental health services).

69 D.C. CODE ANN. § 7-1231.14(b)(1) (2002); N.Y. MENTAL HYG. LAW § 33.21(c) (Consol. 2002); see also CAL. FAM. CODE § 6924 (West 1994) (stating that a minor who is twelve years or older may consent to mental health treatment or counseling on an outpatient basis, or to residential shelter services if the minor is mature enough to participate intelligently in outpatient or residential shelter services and the mental health provider determines that the minor poses a serious physical or mental harm to himself or others or is the alleged victim of incest or child abuse).

70 CONN. GEN. STAT. ANN. § 19a-14-c (West 1998).

71 MICH. COMP. LAWS ANN. § 330.1707 (West 2001).

72 OHIO REV. CODE ANN. § 5122.04(A) (Anderson 2000).

73 FLA. STAT. ANN. § 394.4784(1) (West 2002).

74 MICH. COMP. LAWS ANN. § 330.1707(1) (West 2001) (disclosure to parents after six sessions or thirty days is not required unless a mental health professional determines that there is “compelling need for disclosure based on substantial probability of harm to minor or to other persons and minor is notified of mental health professional's intent to inform parent or guardian”); OHIO REV. CODE ANN. § 5122.04(A)-(B) (Anderson 2000) (stating that a mental health professional will not inform a minor's parent of that minor's treatment unless there is a “compelling need for disclosure based on substantial probability of harm to the minor or another individual and if the minor is notified of the mental health professional's intent to inform the minor's parent, [or] guardian”); OR. REV. STAT. § 109.680 (2001) (mental health provider may advise parents of the minor's treatment when clinically appropriate to advance the minor's best interests).

75 CONN. GEN. STAT. ANN. § 19a-14-c(d) (West 1998); MD. CODE ANN., HEALTH-GEN. § 20- 104(c) (2001); MICH. COMP. LAWS ANN. § 330.1707(4) (West 2001); OHIO REV. CODE ANN. § 5122.04(c) (Anderson 2000).

76 LA. CH. C art. 1467 (1995) (knowing and voluntary consent by minor for inpatient care is required, including a finding that minor has ability to understand nature of treatment facility); TEX. HEALTH & SAFETY CODE § 572.001(a) (2002) (a person sixteen years or older or a married individual younger than sixteen may consent to inpatient mental health care).

77 Compare MICH. COMP. LAWS ANN. § 330.1707 (West 2001) (excluding only outpatient services and psychotropic medications from the scope of adolescent consent), with D.C. CODE ANN. § 7-1231.14 (2002) (a person sixteen years or older may consent to psychotropic medication if parent or guardian is not available and the treating physician determines that the minor has capacity to consent for clinically indicated medication); N.Y. MENTAL HYG. LAW § 33.21(c)(2) (2002) (a person sixteen years or older may consent to psychotropic medications once a second physician who specializes in psychiatry and is not an employee of the mental health facility has determined that the minor has capacity for decision-making and the medication would serve the minor's best interests). The decision to administer psychotropic medications shall be provided to the parents or guardian and documented in the clinical record. Id.

78 See, e.g., R.I. GEN. LAWS § 23-4.6-1 (2001).

79 ARIZ. REV. STAT. ANN. § 44-132(A) (West 1994).

80 KY. REV. STAT. ANN. § 214.185(3) (Michie 1998); ME. REV. STAT. ANN. tit. 22, § 1503 (West 1992 & Supp. 2001); MD. CODE ANN., HEALTH-GEN. § 20-102(1) (2002); MASS. GEN. LAWS. ch. 112, § 12F (2000); MONT. CODE ANN. § 41-1-402(1)(a) (2001); OKLA. STAT. ANN. tit. 63, § 2602A(1) (West 1997); R.I. GEN. LAWS § 23-4.6-1 (2002); VA. CODE ANN. § 54.1-2969 F (Michie 1999).

81 ALASKA STAT. § 25.20.025 (Michie 2001); KY. REV. STAT. § 214.185(3) (Michie 2001); MD. CODE ANN., HEALTH-GEN. § 20-102(a)(2) (2000); MINN. STAT. ANN. § 144.342 (West 1998); MONT. CODE ANN. § 41-1-402(1)(a) (2001).

82 MD. CODE ANN., HEALTH-GEN. § 20-102(c)(4) (2000); MONT. CODE ANN. § 41-1-402(1)(c) (2001).

83 PA. STAT. ANN. tit. 35, § 10101 (West 1993).

84 MONT. CODE ANN. § 41-1-402(1)(a) (2001); PA. STAT. ANN. tit. 35, § 10101 (West 1993).

85 ME. REV. STAT. ANN. tit. 22, § 1503 (West 1992 & Supp. 2001) (sixty day period attached to living separately and independently); MINN. STAT. ANN. § 144.341 (West 1998) (no time period indicated); MONT. CODE ANN. § 41-1-402(1)(b) (2001) (no time period indicated); OKLA. STAT. ANN. tit. 63, § 2602(A)(2) (West 1997) (no time period indicated).

86 ME. REV. STAT. ANN. tit.22, § 1503 (West 1992 & Supp. 2001); MASS. GEN. LAWS ch. 112, § 12F (2000).

87 See, e.g., MONT. CODE ANN. § 41-1-402(d)(2) (2001); OKLA. STAT. ANN. tit. 63, § 2602A(4) (West 1997); VA. CODE ANN. § 54.1-2969(G) (Michie 1999).

88 See, e.g., ALA. CODE § 22-8-47(b) (1997); KY. REV. STAT. ANN. § 214.185(5) (Michie 1998); MASS. GEN. LAWS ch. 112, § 12F (2000); MINN. STAT. ANN. § 144.345 (West 1998); OR. REV. STAT. § 109.685 (2001).

89 VA. CODE ANN. § 16.1-334 (Michie 1999); see also N.M. STAT. ANN. § 32A-21-5 (Michie 1999) (adding to emancipated status the purchase and sale of real property and the termination of vicarious liability of parents or guardians for minors’ torts).

90 NEV. REV. STAT. 129.130(3), (5) (2001).

91 Id. at 129.130(6).

92 See, e.g., CAL. FAM. CODE § 7050 (West 1994); CONN. GEN. STAT. ANN. § 46b-150d (West 1998); MONT. CODE ANN. § 41-1-402(1)(a) (2001); NEV. REV. STAT. 129.130(d) (2001); VA. CODE ANN. § 16.1-334(1) (Michie 1999).

93 OKLA. STAT. ANN. tit. 63, § 1-532.1 (West 1997).

94 See, e.g., Hartman, supra note 13, at 118 (referring to a study showing that primary care physicians, particularly pediatricians, believe that deference to medical judgment is warranted).

95 See, e.g., ARIZ. REV. STAT. ANN. § 44.132.01 (West 1994); CAL. FAM. CODE § 6926 (West 1994); DEL. CODE ANN. tit. 16, § 710(a) (1999); IDAHO CODE § 39.3801 (Michie 2002); ME. REV. STAT. ANN. tit.22, § 1502 (West 1992 & Supp. 2001); MONT. CODE ANN. § 41-1-402(1)(a) (2001); NEV. REV. STAT. 129.050 (2001); OHIO REV. CODE ANN. § 2907.29 (Anderson 2000); OR. REV. STAT. § 109.610 (2001); PA. STAT. ANN. tit. 35, § 10101 (West 1993); WASH. REV. CODE ANN. § 70.24.110 (West 2002).

96 See, e.g., COLO. REV. STAT. § 25-4-402(4) (2001); CONN. GEN. STAT. ANN. § 19a-216 (West 1998); KAN. STAT. ANN. § 65-2892a (1992); KY. REV. STAT. ANN. § 214.185(1) (Michie 1998); MISS. CODE ANN. § 41-41-13 (1999); W.VA. CODE § 16-4-10 (Michie 2001).

97 BARBEL INHELDER & JEAN PIAGET, THE GROWTH OF LOGICAL THINKING FROM CHILDHOOD TO ADOLESCENCE: AN ESSAY ON THE CONSTRUCTION OF FORMAL OPERATIONAL STRUCTURES (Anne Parsons & Stanley Milgram trans., 1958).

98 Elkind, David, Inhelder and Piaget on Adolescence and Adulthood: A Postmodern Appraisal, 7 PSYCHOL. SCI. 216 (1996)CrossRefGoogle Scholar; GIL G. NOAM, BEYOND FREUD AND PIAGET: BIOLOGICAL WORLDS—INTERPERSONAL SELF, IN THE MORAL DOMAIN: ESSAYS IN THE ONGOING DISCUSSION BETWEEN PHILOSOPHY AND THE SOCIAL SCIENCES 360-399 (Thomas E. Wren, ed. 1990); William Gardner et al., supra note 29.

99 Hartman, supra note 13; Ginsburg et al., supra note 13; Scherer, supra note 13; Weithorn & Campbell, supra note 13.

100 Ambuel & Rappaport, supra note 13; Lewis, supra note 13, at 448.

101 Crosby-Currie, Catherine A., Children's Involvement in Contested Custody Cases: Practices and Experiences of Legal and Mental Health Professionals, 20 LAW & HUMAN BEHAV. 289 (1996)CrossRefGoogle Scholar; Garrison, supra note 13; Scott, Elizabeth S. et al., Children's Preference in Adjudicated Custody Decisions, 22 GA. L. REV. 1035 (1988)Google Scholar.

102 Grisso, supra note 13.

103 Garrison, supra note 13, at 84-85; Grisso, supra note 13, at 1157; Scherer, supra note 13, at 444; Weithorn & Campbell, supra note 13, at 1591-95.

104 See MISS. CODE ANN. § 41-41-13 (1999) (stating that a physician or nurse practitioner “who renders medical care to a minor for treatment is under no obligation to inform the parent or guardian about such treatment”); W.VA. CODE § 60A-5-504(e) (Michie 2001) (stating that licensed physicians may treat an adolescent under this provision without risk of civil or criminal liability).

105 Beier, Sharon R. et al., The Potential Role of an Adult Mentor in Influencing High-Risk Behaviors in Adolescents, 154 ARCHIVES PEDIATRICS & ADOLESCENT MED. 327 (April 2000)CrossRefGoogle ScholarPubMed; Scherer & Reppucci, supra note 13.

106 See Hartman, supra note 13, at 114-15.

107 See Planned Parenthood v. Casey, 505 U.S. 833 (1992) (approving parental consent provision); Bellotti v. Baird, 443 U.S. 622 (1979) (same); Lampert v. Wicklund, 520 U.S. 292 (1997) (upholding parental notification requirement); H.L. v. Matheson, 450 U.S. 398 (1981) (same). For thoughtful discussions about judicial interpretation and issues specific to parental notification and consent statutes, see Ehrlich, J. Shoshanna, Journey Through the Courts: Minors, Abortion, and the Quest for Reproductive Fairness, 10 YALE L.J. & FEMINISM 1 (1998)Google ScholarPubMed; Friedman, Jennifer C., Parental Notice in State Abortion Statutes: Filling the Gap in Constitutional Jurisprudence, 29 COLUM. HUM. RTS. L. REV. 437 (1998)Google Scholar; Schmidt, Catherine Grevers, Where Privacy Fails: Equal Protection and the Abortion Rights of Minors, 68 N.Y.U. L. REV. 597 (1993)Google ScholarPubMed.

108 Beier et al., supra note 105.

109 Ambuel & Rappaport, supra note 13.

110 Id.; Lewis, supra note 13, at 448-49.

111 See Troxel v. Granville, 530 U.S. 57, 65-66 (2000) (reiterating the “cardinal” rule that “custody, care, and nurturance” of minors reside first with the parents) (quoting Prince v. Massachusetts, 321 U.S. 158, 166 (1944)); accord Pierce v. Soc’y of Sisters, 268 U.S. 510 (1925).

112 See 410 ILL. COMP. STAT. ANN. 210/4 (West 1997); see also HAW. REV. STAT. ANN. § 577-26(f) (Michie 1999) (requiring professional attempts “to open lines of communication” between adolescent and family); MICH. COMP. LAWS ANN. § 333.1707(2) (West 2001) (promoting family relationships and cautioning that minor self-consent “not undermine the values that the parent, guardian, or person in loco parentis has sought to instill in the minor”); WIS. STAT. § 51.47 (2001) (mandating parental notification “as soon as practicable”).

113 Cutler, Ellen M. et al., Parental Knowledge and Attitudes of Minnesota Laws Concerning Adolescent Medical Care, 103 PEDIATRICS 582, 583 (1999)CrossRefGoogle ScholarPubMed.

114 Beier et al., supra note 105, at 331.

115 CAL. FAM. CODE § 6929(b) (West 1994).

116 Id. § 7050.

117 Id. § 6929(g).

118 Id. § 6929(b); see DEL. CODE ANN. tit. 16, § 710 (1999); GA. CODE ANN. §§ 31-17-7(b), 31-17-8(c) (2001); HAW. REV. STAT. ANN. § 577-26(a) (Michie 1999); 410 ILL. COMP. STAT. ANN. 210/5 (West 1997); KY. REV. STAT. ANN. § 214.185(6) (Michie 1998); LA. REV. STAT. ANN. § 41:1065.1(c) (West 2000); MD. CODE ANN., HEALTH-GEN. § 20-102(f) (2000). Notably, Montana protects adolescent confidentiality by a separate legislative provision. The provision, however, is laden with broad exceptions that tend to thwart any confidentiality policy intended to protect minors. These exceptions include presentation or anticipation of a severe complication; necessitation of major surgery or hospitalization; jeopardy to health and safety of minor or public; disclosure beneficial to minor's physical or mental health and to family harmony; and desirability of payment commitment from parents. MONT. CODE ANN. § 41-1-403 (2001).

119 Hartman, supra note 13, at 113 (finding that physician practices with adolescent patients “suggest a reciprocal relationship for confidentiality perceived by both physicians and adolescent patients, … bolster[ing] the therapeutic nature of confidentiality that has traditionally been associated with other bioethical principles, including beneficence (promotion of patient health and well-being), nonmaleficence (doing no harm), and autonomy (respect for patient wishes)”).

120 Ginsburg et al., supra note 13, at 1917.

121 MASS. GEN. LAWS ANN. ch 112, § 12F (2000). Similar to Massachusetts, other states restrict the scope of a healthcare provider's professional responsibility to disclose by requiring the provider to make factual determinations related to the risk of disclosure. See, e.g., ME. REV. STAT. ANN. tit. 32, § 2595 (West 1992 & Supp. 2001) (relieving licensed professionals of any obligation to inform parent or guardian about treatment provided to minor for venereal disease, substance dependency or sexual assault); MICH. COMP. LAWS ANN. § 330.1701 (West 2001) (parents shall not be informed without minor's consent unless there is a “compelling need of disclosure based on substantial probability of harm” or if minor is notified of the health professional's intent to inform a parent or guardian); VA. CODE ANN. § 54.1-2969 (Michie 2002) (release of information concerning treatment for venereal disease, birth control, prenatal care or drug dependency contained in medical record not required without prior written consent by minor); W.VA. CODE ANN. § 16-29-1 (Michie 2001) (same).

122 Cruzan v. Dir., Mo. Dep’t. Health, 497 U.S. 261, 261 n.7 (1990).

123 42 U.S.C. 1395 (1992 & Supp. 2000).

124 See, e.g., 20 PA. CONS. STAT. § 5404(a) (2002).

125 See GARY B. MELTON ET AL., NO PLACE TO GO: THE CIVIL COMMITMENT OF MINORS (1998); Redding, Richard E., Children's Competence to Provide Informed Consent for Mental Health Treatment, 50 WASH. & LEE L. REV. 695 (1993)Google ScholarPubMed.

126 See Rosato, Jennifer L., The Ultimate Test of Autonomy: Should Minors Have a Right to Make Decisions Regarding Life-Sustaining Treatment, 49 RUTGERS L. REV. 1 (1996)Google ScholarPubMed; Hawkins, Susan D., Note, Protecting the Rights and Interests of Competent Minors In Litigated Medical Treatment Disputes, 64 FORDHAM L. REV. 2075 (1996)Google Scholar; Hawkins, Lisa Anne, Note, Living-Will Statutes: A Minor Oversight, 78 VA. L. REV. 1581 (1992)CrossRefGoogle ScholarPubMed.

127 Hartman, supra note 5.

128 Id. at 1355-62; see also Hartman, supra note 13, at 132 (advocating for a President's Commission for the Study of Adolescence to examine specific issues impacting adolescence and for this commission to act in collaboration with Congressional action).

129 Leikin, Sanford, A Proposal Concerning Decisions to Forego Life-Sustaining Treatment for Young People, 115 J. PEDIATRICS 17 (1989)CrossRefGoogle Scholar; see also Leikin, Sanford, The Role of Adolescents in Decisions Concerning Their Cancer Therapy, 71 CANCER SUPP. 3342, 3346 (1993)3.0.CO;2-I>CrossRefGoogle ScholarPubMed (stating that “[i]f the patient's competence is maximal, the physician should advocate for the teenager's selfdetermination”) [hereinafter Leikin, Cancer Therapy].

130 As Leikin concedes, criteria to determine medical decision-making ability—the ability to understand information about one's condition and treatment options, the ability to deliberate based on one's values and the ability to choose among options—are employed in adult patient capacity assessments. See generally Appelbaum, Paul S. & Grisso, Thomas, Assessing Patients’ Capacities to Consent to Treatment, 319 NEW ENG. J. MED. 1635 (1988)CrossRefGoogle ScholarPubMed. The criteria employed for adult capacity assessments may be inappropriate for determining adolescent decision-making capability. That is, adolescents may in fact be decisionally capable, but their capacity is not being measured appropriately. See Hartman, supra note 13, at 123-124 & n.148.

131 Leikin, supra note 129, at 21.

132 Id. at 22.

133 Id. at 21-22.

134 Rosato, supra note 126, at 102-03.

135 Id. at 101.

136 Id. at 101-02.

137 Rosato, supra note 126, at 9, 34-49.

138 Id.

139 Daaleman, Timothy P. & VandeCreek, Larry, Placing Religion and Spirituality in End-of- Life Care, 284 JAMA 2514, 2516 (2000)CrossRefGoogle ScholarPubMed.

140 Tulsky, James A. et al., Opening the Black Box: How Do Physicians Communicate About Advance Directives?, 129 ANNALS INTERNAL MED. 441, 446 (1998)CrossRefGoogle ScholarPubMed.

141 Leikin, Cancer Therapy, supra note 129, at 3344.

142 AM. ACAD. OF PEDIATRICS, COMMITTEE ON BIOETHICS, Guidelines on Forgoing Life- Sustaining Medical Treatment, 93 PEDIATRICS 532, 535 (1994)Google Scholar.

143 AM. ACAD. OF PEDIATRICS, COMMITTEE ON BIOETHICS, Palliative Care for Children, 106 PEDIATRICS 351, 354 (2000)Google Scholar.

144 AM. ACAD. OF PEDIATRICS, COMMITTEE ON BIOETHICS, supra note 142.

145 Id.

146 Id.

147 See In re Rosebush, 491 N.W.2d 633, 639 (Mich. Ct. App. 1992); In re Fiori, 673 A.2d 905, 912 (Pa. 1996).

148 AM. ACAD. OF PEDIATRICS, COMMITTEE ON BIOETHICS, supra note 142.

149 One state court has urged physicians, due to expertise and training, to determine an adolescent patient's maturity in judgment. See Belcher v. Charleston Area Med. Ctr., 422 S.E.2d 827, 837 (W.Va. 1992). Scientific findings suggest that primary care physicians believe they should be able to make this determination, though continued study is necessary to learn more about how the determination should be made and what evidence is sufficient to determine maturity. See Hartman, supra note 13, at 118.

150 AM. ACAD. OF PEDIATRICS, COMMITTEE ON BIOETHICS, supra note 142, at 535. The Academy identifies delirium, dementia, depression, mental retardation, psychosis, intoxication, stupor, coma or a patient's refusal as bases for professional inquiry into decision-making capacity. Id.

151 497 U.S. 261, 261 n.7 (1990).

152 See 42 U.S.C. 1395 (1992 & Supp. 2000).

153 See CAL. FAM. CODE § 6929(b), (g) (West 1994); see also supra notes 115-119 and accompanying text.

154 Hartman, supra note 13.

155 Ginsburg, et al., supra note 13, at 1917.

156 D.C. CODE ANN. § 7-1231.02 (2002).

157 See Hartman, supra note 13, at 123-24; Lexcen, Frances J. & Reppucci, N. Dickon, Effects of Psychopathology on Adolescent Medical Decision-Making, 5 U. CHI. L. SCH. ROUNDTABLE 63, 105-06 (1998)Google Scholar; Gardner et al., supra note 29, at 898.

158 Belcher v. Charleston Area Med. Ctr., 422 S.E.2d 827 (W.Va. 1992); In re E.G., 549 N.E.2d 322 (Ill. 1989).

159 In re Application of Long Island Jewish Med. Ctr., 557 N.Y.S.2d 239, 243 (Sup. Ct. 1990).

160 In re Rosebush, 491 N.W.2d 633 (Mich. Ct. App. 1992) (Sawyer, J., dissenting); see also Commonwealth v. Nixon, 761 A.2d 1151, 1155 (Pa. 2000).

161 Belcher, 422 S.E.2d at 827.

162 Id.

163 Id. at 829-31.

164 See id. at 830.

165 Id. at 835-36.

166 Id. at 838.

167 Id. at 837; see also In re Rosebush, 491 N.W.2d 633, 636-37 (Mich. Ct. App. 1992) (rejecting a “single, static formula” for determining the efficacy of decision-making for de-escalation of medical treatment).

168 Hartman, supra note 13, at 118. See also Doig, Christopher & Burgess, Ellen, Withholding Life-Sustaining Treatment: Are Adolescents Competent to Make These Decisions?, 162 CANADIAN MED. ASS’N 1585 (2000)Google ScholarPubMed (contending that physicians “should assess an adolescent's ability to comprehend and reflect on choices, [and] balance values … to understand the implications of treatment decisions. Given that most adolescents have the capacity necessary to make competent health care decisions, the ethical physician should respect this and allow the competent adolescent the right to exercise autonomy”).

169 For discussion about the enigmatic quality of maturity specific to adolescence, see Hartman, supra note 13, at 104-05; Lexcen & Reppucci, supra note 157, at 75; Steinberg, Laurence & Cauffman, Elizabeth, Maturity of Judgment in Adolescence: Psychosocial Factors in Adolescent Decisionmaking, 20 LAW & HUM. BEHAV. 249, 253 (1996)CrossRefGoogle Scholar.

170 For an analysis of scholarly assessments related to the mature minor doctrine, see Rosato, Jennifer L., Let's Get Real: Quilting a Principled Approach to Adolescent Empowerment in Health Care Decisionmaking, 51 DEPAUL L. REV. 769, 783 & nn.70-87 (2002)Google Scholar.

171 Lexcen & Reppucci, supra note 157, at 75.

172 Belcher v. Charleston Area Med. Ctr., 422 S.E.2d 827, 837 (W.Va. 1992).

173 Id. at 838-39.

174 In re Application of Long Island Jewish Med. Ctr., 557 N.Y.S.2d 239 (Sup. Ct. 1990).

175 Id.

176 Id. at 240-41.

177 Id.

178 Id. at 241-42.

179 Compare Belcher v. Charleston Area Med. Ctr., 422 S.E.2d 827 (W.Va. 1992), with In re Application of Long Island Jewish Med. Ctr., 557 N.Y.S.2d at 240, 243 (finding that when the patient is a minor, the court must act in the place of parents).

180 In re Application of Long Island Jewish Med. Ctr., 557 N.Y.S.2d at 240, 243.

181 Id. at 241-42.

182 Id. at 243.

183 Id.

184 Ginsburg et al., supra note 13; Dolgin et al., supra note 13, at 26.

185 In re Application of Long Island Jewish Med. Ctr., 557 N.Y.S.2d at 243 n15.

186 Id. at 243.

187 Analytic philosopher and logician Willard Van Orman Quine underscored the value of simplicity when he explained how knowledge is shaped through language, especially in the context of its stimulus conditions and referential apparatus. He wrote, “Observation serves to test hypotheses after adoption; simplicity prompts their adoption for testing … . Simplicity also engenders good working conditions for the continued activity of the creative imagination; for, the simpler the theory, the more easily we can keep relevant considerations in mind.” WILLARD VAN ORMAN QUINE, WORD AND OBJECT 19-20 (1960). Simplicity of testable assertions and theory has also been pivotal for science and policy analysis. See GIANDOMENICO MAJONE, EVIDENCE, ARGUMENT, AND PERSUASION IN THE POLICY PROCESS (1989); POPPER, supra note 14, at 65-66. See generally BARNEY G. GLASER & ANSELM L. STRAUSS, THE DISCOVERY OF GROUNDED THEORY: STRATEGIES FOR QUALITATIVE RESEARCH (1967) (reasoning that the adequacy of any statistical sample depends on the quality of techniques and methodology employed); POPPER, supra note 27 (maintaining that the quality of knowledge is only as good as the process for discovering it).

188 Toulmin, Stephen et al., AN INTRODUCTION TO REASONING (Macmillan Publishing Co. ed. 1984)Google Scholar.

189 POPPER, supra note 14, at 91-92.

190 Commonwealth v. Nixon, 761 A.2d 1151, 1153-55 (Pa. 2000).

191 Id.

192 Id. at 1154. The Pennsylvania high court declined to recognize the mature minor doctrine as a defense to the facts and circumstances presented “without passing comment upon the wisdom of the … doctrine itself.” Id.

193 Id. at 1153-54. The Nixons were members of the Faith Tabernacle Church and believed that illness should be treated spiritually rather than medically. Id. at 1152.

194 See Note, Children as Believers: Minors’ Free Exercise Rights and the Psychology of Religious Development, 115 HARV. L. REV. 2205, 2221 (2002)CrossRefGoogle Scholar (summarizing indeterminate results about minors’ cognitive development related to religious beliefs and the need for continued research).

195 See In re Duran, 769 A.2d 497 (Pa. Super. 2001) (reversing as error a ruling by the Orphan's Court to appoint Maria's husband as an emergency guardian to consent to blood transfusion therapy, despite her express wishes to the contrary that were memorialized by a power of attorney that not only designated a friend from the Jehovah's Witness community as her proxy decision-maker, but clearly stated her reasons for refusing a blood transfusion).

196 Justice Scalia has described the Courts’ stretching or distortion of evidence to achieve a desired result as “thrashing about for evidence.” Atkins v. Virginia, 122 S. Ct. 2242, 2263 (2002) (Scalia, J., dissenting).

197 In re Application of Long Island Jewish Medical Center, 557 N.Y.S.2d 239, 241-243 (Sup. Ct. 1990).

198 569 A.2d 1202 (Me. 1990).

199 580 N.E.2d 876 (Ohio Prob. Ct. 1991).

200 491 N.W.2d 633 (Mich. Ct. App. 1992).

201 In re Swan, 569 A.2d at 1202.

202 Id. at 1203.

203 Id. at 1203-04.

204 Id. at 1205. Chad's mother testified that she and Chad had discussed a highly publicized case involving a step-grandson of a close friend of Chad's grandmother. The step-grandson was in a persistent vegetative state. When she explained to Chad that such a person required total care, she remembered him saying, “‘if I can't be myself … no way … let me go to sleep.’” On another occasion, Chad commented to his brother, following visitation with a hospitalized comatose friend, that “‘I don't ever want to get like that … I would want somebody to let me leave—to go in peace.’” Id.

205 Id.

206 Id. at 1206.

207 In re Guardianship of Crum, 580 N.E.2d 876 (Ohio Prob. Ct. 1991).

208 Id. at 878.

209 Id. at 879-80.

210 Id. at 880-82.

211 Id. at 882.

212 Id. at 883.

213 In re Rosebush, 491 N.W.2d 633 (Mich. Ct. App. 1992).

214 Id. at 635.

215 Id.

216 Id. at 635, 641. Before the appellate court could render its decision, Joelle Rosebush died; the court, however, found review was “nevertheless appropriate because the issues involve questions of public significance that may recur and yet evade review.” Id. at 634.

217 Id. at 635-37.

218 Id. at 636, 636 n.2.

219 See supra notes 129-147 and accompanying text.

220 See ALA. CODE § 22-8A-4 (1997); GA. CODE ANN. § 31-32-3 (a) (2001); N.D. CENT. CODE § 23-06.4-03 (2002); N.H. REV. STAT. ANN. § 137-H:3 (1996); W.VA. CODE § 16-30-4(a) (Michie 2001). But see IDAHO CODE § 39-4504 (Michie 2002) (extending legal validity to advance directive executed by “[a]ny competent person”).

221 20 PA. CONS. STAT. ANN. § 5404(a) (West 1993).

222 See Ginsburg, et al., supra note 13, at 1918 (finding that “[t]eenagers sense of control would be enhanced by allowing them greater autonomy and by enabling them to choose desired [healthcare] services”).

223 In re Jane Doe, 418 S.E.2d 3, 6 (Ga. 1992).

224 In re Rosebush, 491 N.W.2d 633, 639 (Mich. Ct. App. 1992).

225 Belcher v. Charleston Area Med. Ctr., 422 S.E.2d 827, 837 (W.Va. 1992).

226 Maggiolini, supra note 13, at 420 (reporting results from research that examined the impact of the experience of childhood leukemia on a group of adolescents who had the disease cured and finding that the teens appeared “to have reached a greater level of maturity than their peers in almost all areas”).

227 LEO TOLSTOY, THE DEATH OF IVAN ILYCH (Bantam 1981). In a moving passage, Tolstoy describes the dying lawyer who

Id. at 102-103; see also Orwell, George, HOW THE POOR DIE, IN THE ORWELL READER: FICTION, ESSAYS, AND REPORTAGE 90–91 (Harcourt Inc. 1984)Google Scholar (lamenting the loneliness of a slow, painful, “natural” death by observing “Numero 57” die in a Paris hospital bed in the 1930s, who had “just flickered out like a candle and was not even important enough to have anyone watching at his deathbed”); Callahan, Daniel, Death and the Research Imperative, 342 NEW ENG. J. MED. 654, 654 (2000)CrossRefGoogle ScholarPubMed (discussing medicine's denial and evasion of impending death, despite patient wishes to the contrary).

228 In re Swan, 569 A.2d 1202, 1206 (Me. 1990).

229 Morgan, Elaine R. & Murphy, Sharon B., Care of Children Who Are Dying of Cancer, 342 NEW ENG. J. MED. 347, 348 (2000)CrossRefGoogle ScholarPubMed; see Stephenson, Joan, Palliative and Hospice Care Needed for Children with Life-Threatening Conditions, 284 JAMA 2437, 2437 (2000)Google ScholarPubMed (reasoning that, “[b]ecause of the perception that palliative and hospice care are synonymous with giving up and accepting death, many people assume such care is incompatible with trying to save their children”).

230 In re Swan, 569 A.2d at 1206. For instance, the American Academy of Pediatrics has emphasized flexibility in developing treatment plans that “consider all options that may palliate distressing symptoms and conditions.” AM. ACAD. OF PEDIATRICS, COMMITTEE ON BIOETHICS, supra note 143, at 353; see also Morgan & Murphy, supra note 229, at 347-48 (concluding that “a multidisciplinary approach may be best”).

231 In re Guardianship of Crum, 580 N.E.2d 876, 883 (Ohio Prob. Ct. 1991).

232 Daaleman & VandeCreek, supra note 139, at 2515. Several healthcare commentators offer a distinct perspective concerning medical responsibility and respect for spirituality “as an important resource for coping with illness” and for engaging patients as unique persons with spiritual needs. Post, Stephen G. et al., Physicians and Patient Spirituality: Professional Boundaries, Competency, and Ethics, 132 ANNALS INTERNAL MED. 578, 579-580 (2000)CrossRefGoogle ScholarPubMed (advancing physicians’ responsibility to consider “how to support patient spirituality, if and when the patient deems it relevant; [and to note that] spirituality is also to be respected as an expression of patient autonomy”).

233 Reporting on the results of a study about parental understanding of prognosis in minors who die of cancer, the researchers commented:

Wolfe, Joanne et al., Understanding of Prognosis Among Parents of Children Who Died of Cancer: Impact on Treatment Goals and Integration of Palliative Care, 284 JAMA 2469, 2474 (2000)CrossRefGoogle ScholarPubMed. Other researchers also emphasize that “palliative care is applicable from the beginning of an illness— whenever comfort, support, and quality of life are significant concerns.” DAVID BARNARD ET AL., CROSSING OVER: NARRATIVES OF PALLIATIVE CARE 2 (2000). The authors employ qualitative methodologies to report narratives of terminally ill patients; these narratives teach that “many lessons in living [are] learned from the dying.” Id. at v.

234 AM. ACAD. OF PEDIATRICS, COMMITTEE ON BIOETHICS, supra note 142, at 535.

235 Hartman, supra note 13, at 118.

236 Scott et al., supra note 101, at 1051.

237 Belcher v. Charleston Area Med. Ctr., 422 S.E.2d 827, 837 (W.Va. 1992).

238 Id. at 837-38.

239 Id. at 837.

240 A relationship to the law of torts is found by analogy to nonfeasance, a failure to take steps to prevent harm. Liability for nonfeasance is recognized when a person is vulnerable and dependent upon another who wields considerable power over the person's welfare. Fairness may also require the empowered person to assist the vulnerable one. See W. PAGE PROSSER, PROSSER AND KEETON ON TORTS, 5^TH EDITION 373-75 (1984); see also Emerich v. Philadelphia Ctr. for Human Dev., Inc., 720 A.2d 1032 (Pa. 1998); Tarasoff v. Regents of Univ. of Cal., 551 P.2d 334 (Cal. 1976) (imposing upon professionals an affirmative duty to act to protect a third party from harm).

241 In re Winship, 397 U.S. 358 (1970).

242 42 PA. CONS. STAT. ANN. § 6355 (West 1993); PA. STAT. ANN. tit. 50, § 7403 (West 1993).

243 Cruzan v. Dir., Mo. Dep’t. of Health, 497 U.S. 261 (1990) (determining that a clear and convincing evidentiary requirement for patient wishes to forego life-sustaining treatment is inviolate to the right for medical decision-making guaranteed by the Due Process Clause of the Fourteenth Amendment of the federal Constitution).

244 In re Swan, 569 A.2d 1202, 1205-06 (Me. 1990).

245 In re Rosebush, 491 N.W.2d 633, 639 n.7 (Mich. Ct. App. 1992).

246 Id. at 637.

247 In re Guardianship of Crum, 580 N.E.2d 876 (Ohio Prob. Ct. 1991).

248 See generally DANIEL KAHNEMANN ET AL., JUDGMENT UNDER UNCERTAINTY: HEURISTICS AND BIASES (1982); see also DONALD T. CAMPBELL, A TRIBAL MODEL OF THE SOCIAL SYSTEM VEHICLE CARRYING SCIENTIFIC KNOWLEDGE, 1 KNOWLEDGE: CREATION, DIFFUSION, UTILIZATION 181 (1979); IAN MITROFF, THE SUBJECTIVE SIDE OF SCIENCE: PHILOSOPHICAL INQUIRY INTO THE PSYCHOLOGY OF THE APOLLO MOON SCIENTISTS (1974).

249 In re Jane Doe, 418 S.E.2d 3, 4 (Ga. 1992); In re Rosebush, 491 N.W.2d at 638.

250 In re Quinlan, 355 A.2d 647, 672 (N.J. 1976) (counseling that, in cases involving medical decision-making, judges have a “non-delegable responsibility” to be responsive “not only to concepts of medicine but also the common moral judgment of the community at large”).

251 In re Jane Doe, 418 S.E.2d at 4.

252 Id.

253 Id.

254 Id. at 4-5.

255 Id. at 6-7.

256 Id. at 6-7 & n.6.

257 See In re Duran, 769 A.2d 497 (Pa. Super. 2001); In re Application of Long Island Jewish Med. Ctr., 557 N.Y.S.2d 239 (Sup. Ct. 1990).

258 In re Fiori, 673 A.2d 905, 913 (Pa. 1996); accord In re Quinlan, 355 A.2d 647, 672 (N.J. 1976).

259 In re Rosebush, 491 N.W.2d 633, 637 (Mich. Ct. App. 1992).

260 Id. at 638-39.

261 In re Swan, 569 A.2d 1202, 1206 (Me. 1990).

262 Hartman, supra note 5.

263 Hartman, supra note 13, at 133.

264 ALFRED, LORD TENNYSON, TENNYSON's POETRY 82-84 (Robert W. Hill Jr., ed. 1999) (quoting Alfred Lord Tennyson's poem “Ulysses”).