Consent to medical treatment of the mature minor: is autonomy achievable?

Abstract

The philosophy of healthcare is based on autonomy and capacity, autonomy being the patient's right of self-determination and capacity being the patient's ability to make their own decisions. Practitioners are required to consider patient autonomy in all aspects of care to determine what matters to the patient and to act as a facilitator in the patient's decision making. To understand our work with minors who have achieved the capacity to reason to some extent, nurses also need to consider the level of psychological development achieved, the nature of decisions required, the reasoning support available (parents or guardians) and the requirement to act in beneficial ways. The needs of the mature minor are important as much attention is delegated to the notion of capacity, which acts as gatekeeper, determining whether or not the right of autonomy will be respected in each individual's case. However, the relationship between autonomy and capacity is often ambiguous and the capacity to consent might not be constant nor is it easily assessed.