CASE STUDY

Denise is a sixteen-year old 11th grade student who started using marijuana and drinking at fourteen and has used heroin regularly for the past six months. Denise stopped attending school in January and hangs out with her friends. She lives at home with her mother and younger brother, but comes and goes and often isn't seen by her mother for four or five days at a stretch. When Denise was fifteen, her mother, with the assistance of a school-based addiction treatment counselor, was able to get her enrolled in outpatient treatment to address her alcohol and marijuana use. Denise participated in the program and reduced her alcohol and marijuana use. The outpatient program diagnosed Denise with depression and mild anxiety, and she was prescribed medication. Denise seemed to be regaining her health, and she started high school classes in the fall. However, her mother began to notice troubling patterns of more serious drug use in November and was unable to get Denise to resume treatment at her outpatient program.

Denise's mother now wants to have her daughter assessed for enrollment in a residential treatment program. She is afraid of the people her daughter hangs out with and does not want her son to be influenced by his sister's friends and drug use. Denise recently had a scare about her heroin use when one of her friends suffered an overdose and barely survived. She agreed to go for an assessment at a residential program. The program agreed that Denise needed residential treatment and received authorization from the Medicaid managed care organization to provide services for a short length of stay. After three days in treatment, during which she was treated with suboxone to help her withdrawal, Denise began to resist care. She has decided to leave the program against medical advice and her mother's wishes.

Questions:

1) Does alcohol and drug use uniquely affect an adolescent's ability to make decisions about medical care for addiction; and, if so, should clinical and legal standards take this factor into consideration?

2) What if Denise had been arrested for drug possession with intent to distribute, placed in the juvenile justice system, and required to attend residential treatment. How should clinical care decisions and concepts of autonomy be addressed in the legal framework for juvenile justice drug treatment?

CASE STUDY ANALYSIS INSTRUCTIONS

Analyze Case Study throughout the duration of this course. In evaluating your Case Study Analysis, your instructor will apply the Case Study Analysis Grading Rubric. For each case study, you will be asked to answer specific questions based on the content of the scenario provided. Each Case Study Analysis must be presented in paragraph form using current APA formatting (Times New Roman, 12-point font, and double-spaced) and include both a title and reference page. The body of each analysis will consist of 2-3 pages and will require a minimum of 2-3 scholarly references. These can be taken from the assigned reading materials, presentations, or other scholarly references.

The 4 sections required for analyzing the cases are as follows: (write in paragraph form)
1. Identify the Issues
a. What are the major moral issues raised by the case?
b. What are the major factual issues raised by the case?
c. What are the major conceptual issues raised by this case?
d. Who are the major stakeholders in this case?

2. Outline the Options
a. What are the major options on the issues raised by this case?
b. What are the main alternative actions or policies that might be followed in responding to the issues in this case?
c. What facts are unknown or disputed that might be relevant to deciding an action in this case?

3. Construct Your Arguments
a. Identify the principles that can be invoked to support a conclusion as to what ought to be done ethically in this case or similar cases.
b. Determine whether the different moral standards yield converging or diverging judgments about what ought to be done.

4. Make a Decision
a. Decide which of the identified options you would recommend or judge to be the best way to deal with the issue presented in this case based upon which option has the strongest reasons behind it.

b. Determine how a critic of your position might try to argue against it using other reasons and present a rebuttal or counter-argument in defense of your judgment.