Summary

The main learning points from this week are that:

• The mental capacity of children and young people is a result of the interplay between their chronological age, their evolving maturity and the assumptions and responses of others. This means that their mental capacity always needs to be viewed in context.
• There are legally defined age limits for certain decisions and activities, which reflect societal assumptions about the capacity of children and young people.
• Parents have responsibilities and certain legal powers to act on behalf of their children. As children move through their teenage years, the power of parents to make decisions on behalf of a child is legally more negotiable, as evidenced by the Gillick case.
• At age 16, children achieve the legal status of presumed capacity and between 16 and 18, their decision-making powers are increasingly devolved to them. 
• Abuse and exploitation can severely damage a child’s capacity. Assessment of a child who may be subject to abuse or exploitation should take these risks and consequences into account.
• Capacity can be impaired by temporary or fluctuating periods of mental illness. This can usually be treated, although it can be unpleasant and frightening for the child or young person. 

You should now 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.

Next week, you look at the issue of mental capacity in relation to people with learning disabilities.