Adolescents’ capacity for healthcare decision-making is addressed according to their age and/or maturity. Young people over 16 years of age in South Australia, or 18 years of age in other Australian states and territories, can make healthcare decisions for themselves; adolescents under this age threshold must demonstrate their understanding, intelligence and maturity to make their own healthcare decisions, a legal threshold known as the “Gillick competency” or “mature minor principle”.
Assessing an adolescent’s capacity to make healthcare decisions is the responsibility of their treating health practitioner (or the courts in some circumstances). Legal uncertainty of the mature minor principle means health practitioners may not be appropriately considering adolescents’ healthcare decisions, particularly in pre-hospital settings. As such, the practical effect of the mature minor principle may not align with its legal intention.
This paper will explore the limitations of the Gillick competency in a pre-hospital setting and the practical implications for adolescent healthcare decision-making. Little research addresses the legal and practical challenges of adolescent decision-making in the pre-hospital setting. The urgent nature of pre-hospital care means paramedics need to assess an adolescent’s understanding, intelligence and maturity quickly and efficiently. Failing to properly assess an adolescent’s maturity to consent to their own healthcare treatment could breach a well-established common law principle.