While the LO recommends implementing more of a bright-line age system, another option is a maturity standard. One consideration is that the American Academy of Pediatrics Task Force grants informed consent based on the patient's age, disease, severity, prognosis, risks, proposed benefits, level of intelligence, reasoning, emotional state, and cultural perspective.121 In addition, studies have shown that teens can make informed choices just as well as adults with regard to issues such as diabetes, epilepsy, and depression.122
A clear and concise statutory definition of ``mature minor'' could help youths gain accessibility to needed health care. For example, Alabama provides a concrete definition of a mature minor as, "[a]ny minor, who is age 14 or older, or has graduated from high school, or is married, or having been married is divorced or is pregnant may give effective consent to any legally authorized medical, dental, health or mental health services, and the consent of no other person shall be necessary."123 While Massachusetts may use this model as a guide, it should be modified to include even more precise language stipulating those who are eligible to consent for their own medical care. For example, is graduation from high school necessary, or is it sufficient for a student to study for, and obtain, her GED? Massachusetts should take these indications into consideration when drafting legislation, but may wish to use indicators such as ``financial independence,'' ``job procurement,'' and ``school attendance.''
Overall, the Massachusetts consent statutes124 provide a very positive basis from which JRI may seek to expand minors' rights to consent to general health care. The above discussion, along with the summary of recommendations,125 will hopefully move JRI and the next LO toward their goal of expanding the current MMR.
In view of the Massachusetts analysis, it may be useful to consider and analyze the bigger-picture context of minors' consent to health care in terms of how other states deal with the MMR and issues of consent to health care.