Introduction
In 1985, the House of Lords established in Gillick v West Norfolk and Wisbech Area Health Authority that a child under 16 years of age could consent to treatment provided they demonstrated sufficient maturity and intelligence to understand fully what was proposed.1 The test has become the cornerstone of capacity assessment in paediatric and adolescent medicine, adopted across English-speaking jurisdictions,2 offering a legally grounded way to balance children’s emerging autonomy against their need for protection.
That framework was designed to recognise and protect children’s developing autonomy against inappropriate adult over-ride, a challenge that has not diminished. Recent critiques have identified its limitations: Bart and colleagues argued in 2024 that Gillick focuses too narrowly on decisional authority and is silent on the broader conditions of adolescent involvement and called for alternative frameworks.3 To my knowledge, none has addressed the question this paper raises.
The question is…