Clarifying ‘maturity’: Determining children’s capacity for medical consent in South Africa

South African law recognises the evolving capacity of minors to consent to medical treatment. This is manifested in the Children’s Act 2005 which governs minors’ rights and determines that children aged 12 years and above are presumed to have the capacity to consent to medical treatment provided they are of sufficient maturity to understand its nature and consequences. Although the word ‘maturity’ appears repeatedly in the Children’s Act, it does not provide a definition or guidance on how maturity should be determined. This article therefore, first, discusses the meaning of ‘maturity’, ‘sufficient maturity’, and related terminology and, second, elucidates on the role of brain development in the determination thereof in order to propose foundational elements regarding evidence-based guidelines for establishing whether the legally requisite ‘maturity’ to consent to medical treatment is present. The discussion is informed by South African and foreign case law, relevant regulatory instruments, human rights considerations, and literature on child brain development and consent.