The decision-making power of adolescents to refuse medical treatment in South Africa: Lessons from other jurisdictions

Abstract

This paper discusses a controversial issue in relation to the capability of adolescents to refuse life-saving medical treatment. First, it examines the concept of autonomy and the normative framework for the recognition of the right of the child to consent to and refuse medical treatment under international law. Second, it discusses the provisions of South African law on this issue. The paper then draws on the experiences of the courts in the United States of America (US) and the United Kingdom (UK) to highlight good practices and to identify the gaps in the approaches adopted. Using Nedelsky’s relational autonomy as a guide, it concludes by arguing that, in all cases, the need for a dialogue between the child and their parents or guardians is important in helping the child to make an informed decision. Such a dialogue should not be viewed as an unnecessary intrusion into the autonomy of the child, but rather as a way to support the decision-making abilities of the child. isiZulu: Leli phepha lidingida udaba okuphikisanwa ngalo maqondana namandla abantu abasha abangaphansi kweminyaka eyishumi nesishiyagalolunye okwenqaba ukwelashwa ngezindlela ezisindisa impilo. Okokuqala, lihlola isihloko sokuzimela kanye nohlaka lwenqubo lokwazisa amalungelo engane okuvuma kanye nokwenqaba ukwelashwa ngokwezempilo ngaphansi komthetho wamazwe ngamazwe. Okwesibili, lidingida izinhlinzeko zomthetho waseNingizimu Afrika ngalolu daba. Leli phepha libe selisusela imininingo kulokho okwenzeke ezinkantolo zase- United States of America (e-US) kanye nase-United Kingdom (e- UK) kugqanyiswa izinqubo ezilungile futhi kuhlonzwe amagebe ezindleleni ezisetshenzisiwe. Ngokusebenzisa i-Nedelsky’s relational autonomy njengomhlahlandlela, liphetha ngokuveza ukuthi, kuzo zonke izigameko, kubalulekile ukuba kube nengxoxo phakathi kwengane nabazali noma abanakekeli bayo ukuze kusizwe ingane ithathe isinqumo esicatshangisisiwe. Leyo ngxoxo akumele ithathwe njengokuphazamisa okungenasidingo ekuzimeleni kwengane, kodwa kunalokho kumele ithathwe njengendlela yokusekela ukuthatha isinqumo sengane.