Introduction

Mental capacity is a complicated enough topic in relation to adults, for whom the presence or lack of capacity is often highly debatable. For children, however, and especially for young children, there is a general presumption of incapacity, not capacity. Of course, this evolves through childhood, but, as we all know, every child is different. While chronological age is important, it is not the only factor that determines whether decision making should be at the discretion of the parents or the children themselves. This week you explore these issues in greater depth. 

By the end of this week you should be able to:

• describe how a child’s presumed innate incapacity to make important decisions evolves through childhood to capacity 
• explain when and how parental decision making may be shared with or delegated to ‘competent’ children
• explain how the age of 16 is an important threshold for asserting the legal presumption of capacity
• describe some of the difficulties and ambiguities relating to capacity for young people aged 16 and 17
• describe two examples of exceptional situations where the capacity of a child or young person may be especially compromised: child sexual exploitation and the interface with mental health services and law