Ethical challenges faced by health professionals in assessing children’s maturity and mental capacity to consent to medical treatment as provided for in Section 129 (2) of the Children’s Act

Abstract

Section 129(2) of the Children’s Act allows children aged 12 and older to consent to their own medical treatment. The validity of this consent is determined by a health professional's assessment of the child’s maturity and mental capacity to understand the benefits and consequences of the proposed treatment. However, there are currently no guidelines to help health professionals conduct these assessments. This paper aims to address a normative question: in the absence of clear guidelines for assessing children's maturity and mental capacity, could Section 129(2) potentially violate children's right to autonomy? I argue that without proper guidelines, there is indeed a risk of infringing on children's autonomy. To support my argument, I present three main points: First, the competence of health professionals to assess a child's maturity and mental capacity is questionable, as the Act does not specify who should carry out these assessments. Second, there are no specific assessment tools designed for this purpose, raising concerns about the validity and reliability of any measures currently in use. Third, the Act itself is vague and ambiguous, failing to define key concepts, such as "sufficient maturity." Finally, when viewed through the lenses of Utilitarianism and Kantian deontology, Section 129(2) lacks ethical support. In conclusion, given the potential for violating children's right to autonomy, there is an ethical imperative to amend Section 129(2) of the Children’s Act.