Developmental change in adolescents' psychological and legal competence to consent to abortion: An empirical study and quantitative model of social policy

I present an empirical study of adolescents' competence to consent to abortion, and a mathematical model for comparing alternative social policies governing adolescent abortion. The empirical study examines the legal assumption that minors are not competent to consent to abortion, and assesses age and psychosocial variables as predictors of legal competence. Participants are 75 females, age 13 to 21, who suspect an unplanned pregnancy and come to a cooperating clinic for a pregnancy test. Volitional and cognitive facets of legal competence are assessed using a structured interview which is audio taped then analyzed by content analysis. One dimension of volitional competence is identified ($Volition$), and three dimensions of cognitive competence (thorough consideration of consequences, Consequences; number of reasons considered, Richness; and, quality of reasoning process, Global Quality). MANOVA is used to compare these 4 criteria of competence in a 3 by 2 design, with three age groups (13-15; 16-17; 18-21), and participants who consider abortion vs. participants who do not. Only 13-15 year old minors who do not consider abortion have lower scores than legal adults in Volition, Consequence, and Global Quality. In regression analysis with participants who consider abortion, age predicts all cognitive criteria, but not Volition. Social support, abortion knowledge, and other psychosocial variables predict all 4 criteria. When combined, age and psychosocial variables each make significant contributions to predicting cognitive competence. To examine policy implications of these empirical results, I developed a mathematical model which systematically compares the utility of alternative social policies across a universe of social values. Three policies are compared: (A) All minors are presumed incompetent; (B) All minors are presumed competent; and (C) Minors age 16 and 17 are presumed competent, and younger minors incompetent. Policies B and C perform well across a wide variety of values. Policy A performs poorly except under a narrow range of values. This method of analysis can be applied to other policy questions where divergent values are a significant component of debate. Results from both studies challenge the validity and utility of the common policy presumption that minors under age 18 are not competent to consent to abortion.U of I OnlyETDs are only available to UIUC Users without author permissio