Adolescent vicissitudes and medical judgement: a case study

Professional concern about the widespread occurrence of adolescent pregnancy is based upon its negative impact on the social, developmental, and economic prospects of the mother and her infant. The usual presumption is that the pregnant adolescent is in good health but suffers from socioeconomic and cultural disadvantages, which the pregnancy will exacerbate. The problems of the pregnant adolescent are more complex when she also has a severe medical handicap. We draw upon such a case to illuminate the issues which arise when medical problems interact with the vicissitudes of adolescence. Although it is clear that the patient's own behavior contributed substantially to the tragic outcome of this case, we believe that greater professional anticipation of the contingencies of adolescent development might have produced a more favorable result.