The College of Optometrists

Children and young people with the capacity to consent

A child or young person’s ability to make decisions depends more on their ability to understand and weigh up options, than on their age. When assessing a young person’s capacity to make decisions, you should bear in mind that:
  1. a child may have capacity to make decisions if you consider them to be capable of understanding the nature, purpose and possible consequences of the proposed examination and treatment, as well as the consequences of non-treatment,213, 214 and
  2. at 16 a young person is presumed to have capacity to make most decisions about their treatment.
You should encourage the child or young person to involve their parents in making decisions, unless the child or young person wishes to exclude them.
You must get the child or young person’s consent to sharing their information if you involve the family.
If a child with the capacity to consent has consented to treatment that you consider is in the child’s best interests, parents cannot override this.
If a child with the capacity to consent refuses treatment, the parents, or a court, can override this decision. In Scotland, those with parental responsibility cannot authorise procedures that a child with capacity to consent has refused.
If a young person with the capacity to consent refuses treatment, the law in England, Wales and Northern Ireland is complex on whether parents can override this refusal.
Although unlikely to occur in optometric practice, if a competent child or young person refuses treatment, which you feel is in their best interests, you should contact your professional or representative body for advice.


See section on Safeguarding children and vulnerable adults.


213 Gillick-v-West Norfolk and Wisbech Area Health Authority [1985] 3 All ER 402
214 In Scotland the Age of Legal Capacity (Scotland) Act 1991, s.2(4) states that a person under the age of 16 years shall have legal capacity to consent on his own behalf to any surgical, medical or dental procedure or treatment where, in the opinion of a qualified medical practitioner attending him, he is capable of understanding the nature and possible consequences of the procedure or treatment.

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