As a young person gets older, you may have questions about making decisions on their behalf around key topics such as their health and finances. The following pages have a variety of information for parents and carers around decision making and moving into adulthood.
Gillick Competency
Health practitioners may enable some children and young people to make decisions about their own care before they get to 16 years if they have sufficient maturity and understanding. This is known as ‘Gillick Competence’.
For example, they may be able to decide whether they want to:
- Go ahead with a brace for their teeth
- Get a vaccination
- Attend physiotherapy appointments
- Have an operation.
This does not apply to all children, just those who can demonstrate the level of understanding and maturity required to make an informed decision.
If the young person demonstrates that they have the understanding and maturity to make a particular decision for themselves, then they may do so. They will be encouraged to discuss decisions with their parents/carers, but they can still make a decision that their parents think is unwise.
If they can’t demonstrate that they have the understanding and maturity, parents / carers will make the decision, but they should take into account the young person’s feelings on the matter.
Decisions at 16
In healthcare, a practitioner’s starting point will be that young people aged 16 are assumed to make their own decisions.
If there is a concern that the young person does not understand, or cannot retain, weigh, or communicate information in relation to the particular decision, practitioners will assess their mental capacity.
Every effort will be made to give them the right information, at the right time, in the right way to help them to make the decision for themselves. This is known as ‘Practicable Steps’. Practitioners will ensure that all practicable steps have been taken that are relevant for the young person to engage with the assessment.
Parents and carers usually play a really important role in supporting the young person and helping them to understand what is being asked.
If it is still not possible for the young person to make their own decision, the practitioner will make a decision that is in their ‘best interests’. This considers lots of different factors, including the views of the people who know the young person best (including parents and carers).
The law says it is legal to have sex from the age of 16, whether you are gay, straight or bisexual, as long as a person is deemed to have the mental capacity to consent.
The aim of the law is to protect the safety and rights of young people and make it easier to prosecute people who pressure or force others into having sex when they don’t want to. Forcing someone into having sex is a crime.
The legal framework for assessing a person's capacity to consent to sexual relations is based on the Mental Capacity Act (MCA) 2005 and the MCA Code of Practice 2007. The MCA presumes that a person has capacity to consent unless it's proven that they lack capacity.
Mental capacity can fluctuate over time, so someone may lack capacity at one time but be able to make the same decision later.
Decisions at 18
In terms of healthcare, not much changes when the young person gets to 18 years. If a young person is ‘Gillick Competent’, then they can make decisions from 14-16 years old.
At 16 years old, they are already assumed in law to be able to make their own decisions. If there are concerns about the person’s capacity to make health related decisions at 16 years, mental capacity assessments would be completed by the relevant professional and best interests decisions made.
