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Barnets röst i vårdens korridorer - En komparativ studie om barns rätt till delaktighet i hälso- och sjukvården i Sverige och Danmark

Wahlén, Moa LU (2023) LAGF03 20232
Department of Law
Faculty of Law
Abstract
The principle of self-determination is found in international legal sources and in the national healthcare regulations of Sweden and Denmark. It is central in medical law and implies that before a medical examination or treatment is carried out, informed consent must be contained from the patient. The right to self-determination is unlimited for a decision competent adult patient. However, the strength of a child ́s right to participation and whether they have any decision-making authority is a more complicated question.

In the essay, I examine and compare the regulation of children ́s right to participation in healthcare in Sweden and Denmark. I also explore how well the national healthcare legislation of the countries aligns with... (More)
The principle of self-determination is found in international legal sources and in the national healthcare regulations of Sweden and Denmark. It is central in medical law and implies that before a medical examination or treatment is carried out, informed consent must be contained from the patient. The right to self-determination is unlimited for a decision competent adult patient. However, the strength of a child ́s right to participation and whether they have any decision-making authority is a more complicated question.

In the essay, I examine and compare the regulation of children ́s right to participation in healthcare in Sweden and Denmark. I also explore how well the national healthcare legislation of the countries aligns with Article 12 of the Convention on the Rights of the Child, which grants children the right to participation in decisions that involve them. According to Article 12, the child ́s opinion should be given weight in accordance with their age and maturity.

The essay concludes that the countries have chosen to design the regulation of children ́s participation in healthcare differently, and that children ́s opportunities for participation seem somewhat weaker in Denmark. In Sweden, healthcare professionals are entirely referred to individual maturity assessments of each child. Healthcare professionals determine whether the child is mature enough to understand information, foresee the consequences of potential decisions, and can consent to medical procedures on their own. However, there seems to be a general age limit of 15 years in practice, as the Swedish Parliamentary Ombudsmen (JO) has considered a child ́s consent to be a requirement for performing medical procedures at that age. JO has also stated a 12-year limit for the right to refuse non-essential medical interventions. If a Swedish child is deemed sufficiently mature, only their own consent is required. Regardless of age and maturity the child always has the right to be given information and to express their opinion on the matter.

In Denmark, the situation is different, as opposed to Sweden they have chosen to introduce an explicit age limit in the law for when the right to self-determination in healthcare begins for children. On their 15th birthday, Danish children are granted full decision-making authority regarding medical interventions. However, I conclude that the opportunities for younger Danish children to participate in their healthcare seem more limited than for Swedish children. The consent of younger Danish children does not appear to be a necessary of sufficient condition for healthcare to be provided. Healthcare professionals can also limit information and refrain from involving the child in healthcare decisions if it is deemed harmful to the child.

The essay ultimately finds that Sweden ́s healthcare regulations seem to better align with Article 12 of the Convention on the rights of the Child than the healthcare regulations in Denmark. This could be because Sweden has incorporated the Convention on the Rights of the Child into law, while Denmark has chosen not to do so. (Less)
Abstract (Swedish)
Principen om självbestämmande återfinns i internationella rättskällor och även i Sverige och Danmarks nationella hälso- och sjukvårdsreglering. Den är central inom den medicinska rätten och innebär att innan undersökning eller behandling genomförs ska ett informerat samtycke inhämtas från patienten. Självbestämmanderätten konstateras vara obegränsad för en beslutskompetent vuxen patient. Hur stark ett barns rätt till delaktighet är och om de har någon bestämmanderätt är dock en mer komplicerad fråga.

I uppsatsen undersöker och jämför jag regleringen om barns rätt till delaktighet i hälso- och sjukvården i Sverige och Danmark. Jag undersöker även hur väl ländernas nationella hälso- och sjukvårdslagstiftning överensstämmer med artikel 12... (More)
Principen om självbestämmande återfinns i internationella rättskällor och även i Sverige och Danmarks nationella hälso- och sjukvårdsreglering. Den är central inom den medicinska rätten och innebär att innan undersökning eller behandling genomförs ska ett informerat samtycke inhämtas från patienten. Självbestämmanderätten konstateras vara obegränsad för en beslutskompetent vuxen patient. Hur stark ett barns rätt till delaktighet är och om de har någon bestämmanderätt är dock en mer komplicerad fråga.

I uppsatsen undersöker och jämför jag regleringen om barns rätt till delaktighet i hälso- och sjukvården i Sverige och Danmark. Jag undersöker även hur väl ländernas nationella hälso- och sjukvårdslagstiftning överensstämmer med artikel 12 barnkonventionen som tillskriver barn en rätt till delaktighet i beslut som rör dem. Barnets inställning ska enligt artikel 12 tillmätas betydelse utefter dess ålder och mognad.

Uppsatsen landar i slutsatsen att länderna valt att utforma regleringen för barns inflytande i vårdfrågor på olika sätt samt att barns möjlighet till delaktighet verkar något svagare i Danmark än i Sverige. I Sverige hänvisas vårdpersonalen helt och hållet till individuella mognadsbedömningar av varje barn. Vårdpersonalen står för avgörandet om barnet är moget nog att tillgodogöra sig information, överskåda konsekvenser av eventuella beslut och på grund av detta ensamt kan samtycka till vårdåtgärder. Det kan dock uttolkas en generell 15-årsgräns i praxis då JO ansett att barnets samtycke är ett krav för att få utföra vårdåtgärder vid den åldern. Samt en 12-årsgräns för rätten att neka till icke livsnödvändiga åtgärder. Om ett svenskt barn bedöms tillräckligt moget är det endast dennes samtycke som krävs. Barnet har, nästan oavsett vilken ålder och mognad de uppnått, dock alltid rätt till information och att få uttrycka sina åsikter om saken.

På annat sätt förhåller det sig i Danmark där man till skillnad från Sverige har valt att införa en uttrycklig åldersgräns i lag för när rätten till självbestämmande i vården inträder för barn. På 15-årsdagen ges danska barn full bestämmanderätt i fråga om vårdåtgärder. Jag drar dock slutsatsen att yngre danska barns möjligheter till delaktighet verkar mer begränsade än svenska barns. Detta då yngre barns samtycke inte verkar vara en nödvändig eller tillräcklig förutsättning för att vård ska kunna ges. Vårdpersonalen kan även begränsa informationen och låta bli att involvera barnet i vårdfrågan om det anses skadligt för barnet.

Uppsatsen kommer slutligen fram till att Sveriges hälso- och sjukvårdsreglering verkar överensstämma bättre med artikel 12 barnkonventionen än vad den danska gör. Detta skulle kunna bero på att Sverige har inkorporerat barnkonventionen som lag medan Danmark valt att inte göra detta. (Less)
Please use this url to cite or link to this publication:
author
Wahlén, Moa LU
supervisor
organization
course
LAGF03 20232
year
type
M2 - Bachelor Degree
subject
keywords
Socialrätt, Komparativ rätt, Familjerätt, Barnkonventionen, Självbestämmanderätt
language
Swedish
id
9143013
date added to LUP
2024-02-02 12:41:14
date last changed
2024-02-02 12:41:14
@misc{9143013,
  abstract     = {{The principle of self-determination is found in international legal sources and in the national healthcare regulations of Sweden and Denmark. It is central in medical law and implies that before a medical examination or treatment is carried out, informed consent must be contained from the patient. The right to self-determination is unlimited for a decision competent adult patient. However, the strength of a child ́s right to participation and whether they have any decision-making authority is a more complicated question.

In the essay, I examine and compare the regulation of children ́s right to participation in healthcare in Sweden and Denmark. I also explore how well the national healthcare legislation of the countries aligns with Article 12 of the Convention on the Rights of the Child, which grants children the right to participation in decisions that involve them. According to Article 12, the child ́s opinion should be given weight in accordance with their age and maturity.

The essay concludes that the countries have chosen to design the regulation of children ́s participation in healthcare differently, and that children ́s opportunities for participation seem somewhat weaker in Denmark. In Sweden, healthcare professionals are entirely referred to individual maturity assessments of each child. Healthcare professionals determine whether the child is mature enough to understand information, foresee the consequences of potential decisions, and can consent to medical procedures on their own. However, there seems to be a general age limit of 15 years in practice, as the Swedish Parliamentary Ombudsmen (JO) has considered a child ́s consent to be a requirement for performing medical procedures at that age. JO has also stated a 12-year limit for the right to refuse non-essential medical interventions. If a Swedish child is deemed sufficiently mature, only their own consent is required. Regardless of age and maturity the child always has the right to be given information and to express their opinion on the matter.

In Denmark, the situation is different, as opposed to Sweden they have chosen to introduce an explicit age limit in the law for when the right to self-determination in healthcare begins for children. On their 15th birthday, Danish children are granted full decision-making authority regarding medical interventions. However, I conclude that the opportunities for younger Danish children to participate in their healthcare seem more limited than for Swedish children. The consent of younger Danish children does not appear to be a necessary of sufficient condition for healthcare to be provided. Healthcare professionals can also limit information and refrain from involving the child in healthcare decisions if it is deemed harmful to the child.

The essay ultimately finds that Sweden ́s healthcare regulations seem to better align with Article 12 of the Convention on the rights of the Child than the healthcare regulations in Denmark. This could be because Sweden has incorporated the Convention on the Rights of the Child into law, while Denmark has chosen not to do so.}},
  author       = {{Wahlén, Moa}},
  language     = {{swe}},
  note         = {{Student Paper}},
  title        = {{Barnets röst i vårdens korridorer - En komparativ studie om barns rätt till delaktighet i hälso- och sjukvården i Sverige och Danmark}},
  year         = {{2023}},
}