Cardwell v. Bechtol
1987 Tenn. LEXIS 820, 724 S.W.2d 739, 67 A.L.R. 4th 479 (1987)
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Rule of Law:
A minor who has sufficient intelligence and maturity to understand the nature and consequences of a medical treatment may provide effective consent, thereby negating the need for parental consent. This principle is known as the mature minor exception to the common law rule requiring parental consent.
Facts:
- Sandra Cardwell, a 17-year and 7-month-old high school senior, suffered from persistent back pain.
- Her parents had previously taken her to orthopedic specialists who diagnosed a possible herniated disc and recommended hospitalization, a course of action the parents resisted.
- On April 26, 1982, Cardwell drove herself to a family physician for a sore throat, with her mother's permission but without her accompaniment.
- After this appointment, on her own initiative and without her parents' knowledge, Cardwell went to see Dr. E.L. Bechtol, an osteopath who had previously treated her father.
- Cardwell informed Dr. Bechtol of her symptoms and prior diagnoses, and he performed a 15-minute osteopathic manipulative treatment on her neck, spine, and legs.
- Cardwell paid the $25 fee with a blank, signed check from her father's account, which she was permitted to carry and use for expenses.
- Shortly after the treatment, Cardwell began experiencing severe pain, tingling, and numbness in her legs, which progressively worsened until she could not walk.
- She was taken to the emergency room, where tests confirmed a herniated disc, leading to surgery three days later.
Procedural Posture:
- Sandra Cardwell and her parents sued Dr. Bechtol in Anderson County Circuit Court (the trial court), alleging medical malpractice, battery for failure to obtain parental consent, and failure to obtain informed consent.
- At trial, the court granted a directed verdict in favor of Dr. Bechtol on the medical malpractice claim.
- The claims for battery and informed consent were submitted to a jury, which received an instruction on the mature minor exception and returned a general verdict for Dr. Bechtol.
- The Cardwells, as appellants, appealed to the Tennessee Court of Appeals (the intermediate appellate court).
- The Court of Appeals affirmed the malpractice verdict but reversed the verdict on the battery claim, holding that Tennessee did not recognize the mature minor exception.
- The intermediate appellate court remanded the case for a new trial solely on the issue of damages resulting from the technical battery.
- Dr. Bechtol, as appellant, was granted permission to appeal to the Tennessee Supreme Court (the state's highest court).
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Issue:
Does Tennessee recognize a 'mature minor' exception to the common law rule requiring parental consent for the medical treatment of a minor, thereby precluding a claim of battery against a physician who treats a minor with their consent but without parental permission?
Opinions:
Majority - Justice Drowota
Yes. Tennessee law recognizes a 'mature minor' exception to the general rule requiring parental consent for medical treatment. The common law is not static and can be judicially developed to adapt to societal changes. Tennessee law already acknowledges varying degrees of capacity for minors in other areas of law, such as torts and criminal matters, through the 'Rule of Sevens.' Adopting the mature minor exception is a consistent evolution of the common law, supported by societal changes like the lowering of the age of majority to 18. The capacity of a particular minor to consent is a question of fact for the jury, which must consider the minor's age, maturity, experience, and understanding of the specific treatment. In this case, the jury was justified in finding that Sandra Cardwell, at nearly 18, was sufficiently mature to provide valid consent for the osteopathic manipulation, thus negating the battery claim.
Analysis:
This landmark decision officially incorporates the 'mature minor' doctrine into Tennessee's common law, creating a significant exception to the traditional requirement of parental consent for medical treatment. The ruling shifts the legal analysis from a rigid, age-based rule to a flexible, fact-specific inquiry into an individual minor's capacity and maturity. While this provides a crucial defense for healthcare providers against battery claims when treating competent adolescents, it also introduces a degree of uncertainty, as the determination of 'maturity' is ultimately left to a jury. The decision aligns Tennessee with a modern legal trend recognizing the evolving autonomy of older minors in healthcare decision-making.
