All competent adult patients have the moral and legal right to participate in their medical care treatment decisions and to refuse medical treatment even in lifesaving or life-sustaining situations. This includes the right to prepare Advanced Medical Directives concerning their medical care.

In general, active duty patients have the same rights as any other non-active duty patients. However, under certain circumstances, active duty soldiers may not refuse certain life threatening medical or surgical procedures. When an active duty soldier refuses such treatment, the matter is referred to the Office of the Staff Judge Advocate for resolution. Guidance concerning this is covered in AR 600-20, (Army Command Policy and Procedures).

Follow Up from question last lecture:

Minor Parent:

In contrast, adults of ordinary mental capacity, including those of modest intellect, enjoy decision-making autonomy regarding their own medical care.  There is almost universal endorsement of the classical proposition that “Every human being of adult years and sound mind has the right to determine what shall be done with his own body.” [6]  The legal right of medical autonomy is not dependent on education, wisdom, more than usual intelligence, or experience.  Adults as informed as they want to be have the right to make decisions for themselves that others, including others who are better educated, trained or experienced and more wise, consider to be erroneous, misguided, or contrary to the decision-maker’s best interests. 

            Adolescents are somewhere between dependent children, who are to be treated according to perceptions of their best interests formed by their parents or those legally authorized to act in loco parentis (in the place of parents), and independent adults, who are to be treated according to their wishes.  In practice, adolescents whose wishes coincide with health service providers’ views of their best interests are more likely to be considered “mature” (see 5 below). 

            Adults and adolescents capable of autonomy must also bear the consequences of choices they make that are not in their best interests, and may frustrate or damage their best interests.  Further, they bear moral and sometimes legal responsibility for the effects their choices have on others, such as those they infect with STIs, and the children they intentionally or unintentionally produce.

Emancipated minors

            Adolescents achieve mature status by their own development, but they may become self-determining, that is, emancipated, by the acts of their parents or comparable guardians.  The most historical form of emancipation occurred when parents consented to the marriage of their dependent children under age to marry without such consent.  Other forms occurred when legal minors left home for military service or to work and become economically self-supporting, or themselves became parents. Another form occurred when parents abandoned their children to their own means of survival.  A sad modern form occurs when parents die, for instance from HIV/AIDS, and leave their children without adult care-givers. 

However, an adolescent female who voluntarily engages, or proposes to engage, in sexual relations who requests treatment to prevent pregnancy or STIs may appear to be mature; indeed, the maturity of those who do not request such treatment is more open to doubt.  Similarly, a pregnant adolescent who seeks abortion because she is not ready to assume responsibility for a child may be making a mature judgment, even when not appreciating the moral implications of that choice to her parents’ satisfaction.[15]  An adolescent considered incapable of making this decision for herself may seem no more capable of making decisions for the care and raising of a baby.