1. INTRODUCTION

Among the broad range of legal issues influenced by John Eekelaar’s seminal work on children’s rights is the extent to which the decisions of competent minors in regard to medical treatment should be given effect. Under his ‘dynamic selfdeterminism’ approach, the essential starting point to implementing children’s rights is hearing what children say and addressing those views with respect. This imperative is captured in Article 12(1) of the UN Convention on the Rights of the Child (CRC), which provides that: ‘States Parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child.’ Article 12 points to the increasing autonomy rights of children as they develop. The right of a child to have their views given due weight is ongoing as their circumstances change, in order to ensure optimal realisation of the individual personality. Matters that seem important to the child must be taken into account. As Eekelaar explained:

Hearing what children say must therefore lie at the root of any elaboration of children’s rights. No society will have begun to perceive its children as rightsholders until adults’ attitudes and social structures are seriously adjusted towards making it possible for children to express views, and towards addressing them with respect.

The intention is to ‘bring a child to the threshold of adulthood with the maximum opportunities to form and pursue life-goals which reflect as closely as possible an autonomous choice’.

The increasing autonomy rights of a child as they mature until they reach the age of 18, when the CRC no longer applies, require that the child’s wishes be at least an increasingly significant consideration in matters affecting the child. It does not follow, however, that a child’s wishes will necessarily be determinative. The limits on the autonomy of children flow from the welfare principle. This principle, captured in Article 3 of the CRC, requires that the best interests of the child be ‘a primary consideration’ in all actions concerning children.