Deciding with Children S2 Ep1: Determining capacity to decide and refuse

The legal system says that children generally don't have medical decision-making capacity. However, with increasing maturity comes a greater capacity to be involved. This is the basis for doctrines such as the ‘mature-minor’ and ‘Gillick competence’. By including and promoting a child early in their medical consultations, we can contribute to their growth towards independent decision making. However, there are circumstances when a young person’s capacity to make a medical decision isn’t clear. Factors may include intellectual ability, emotional maturity or the decision's complexity. In this episode, we explore these circumstances and ask: how is decisional capacity determined, and who is best placed to make that determination? If the young person wants to make a decision that is not in their best interests, how should we respond? Guests: Clinician: RCH Psychiatrist Dr Andrew Court. Ethicist: A/Prof Rosalind McDougall.