Rewriting the competency rules for children: full recognition of the young person as rights-bearer

The rules regarding the competency of children to consent to medical treatment have traditionally focused on the child's understanding of the proposed treatment. This article argues that this focus has perpetuated an unjustifiably paternalistic attitude to the treatment of children that is inconsistent with obligations under the Convention on the Rights of the Child and the common law's preference for upholding personal autonomy. A new test is therefore proposed, abandoning the presumption of incompetency for adolescents and focusing on the understanding of the right to make medical decisions. The application of the proposed test is examined both from a general point of view and with regard to a particularly vulnerable group of young people: those suffering from mental illness.