# Is the capacity to consent different from the capacity to refuse treatments and procedures in adolescence?

**Authors:** Guilherme Henrique Martins, Kalline Eler, Aline Albuquerque, Rui Nunes

PMC · DOI: 10.1016/j.jped.2025.04.004 · 2025-05-15

## TL;DR

This paper explores whether adolescents have different abilities to consent versus refuse medical treatments, emphasizing the need to respect their autonomy.

## Contribution

The paper argues that the decisional capacity to refuse should not differ from the capacity to consent in adolescence.

## Key findings

- Adolescents' decisional capacity should be robust enough to allow them to refuse treatments.
- The skills required for refusal and consent may vary depending on the context and potential health risks.
- Respecting adolescent autonomy is crucial, even when it involves decisions that may impact their health.

## Abstract

The objective of this article is to broaden the discussion on the factors that constitute adolescent healthcare decisional capacity, ensuring that adolescents are recognized as capable of refusing treatments or procedures.

Materials from different sources were analyzed, including articles from reputable databases and documents from government agencies, forming a purposefully selected sample. The research was conducted in two phases: document selection and reflective analysis, followed by a report. The discussion was approached from a phenomenological perspective, with reflections grounded in human rights principles.

Healthcare decisional capacity must be sufficiently robust to allow adolescents to refuse treatments or procedures. It is essential to respect the right of capable adolescents to refuse treatments and procedures. Protecting the vulnerability of adolescent patients involves honoring their growing autonomy. Data from field research regarding the refusal of treatments and procedures in adolescence are scarce, which limits the scope of the proposed discussion.

It cannot be argued that adolescents should have different abilities to refuse a treatment or procedure compared to those required to give consent. The importance of these skills seems to vary between these situations. This difference is justified by the need to consider potential harm to health, even though it could be argued that damage to health should be part of the bioethical deliberation surrounding the decision, rather than a factor in the assessment of decisional capacity.

## Full-text entities

- **Diseases:** damage to health (OMIM:603663)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12276603/full.md

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Source: https://tomesphere.com/paper/PMC12276603