Court Cases & Orders

When Parents and Mature Minors Disagree: How Does the Court Decide? 

Written by Russell Alexander / (905) 655-6335

When Parents and Mature Minors Disagree: How Does the Court Decide? 

As we discussed in the first of this three-part Blog series, when it comes to a young person’s decision-making around their own health care, Canadian law recognizes the concept of a “mature minor.”  This concept stems from the legal principle – which is endorsed by Canadian public policy – that a child or adolescent who is technically still a minor should nonetheless have the right to make medical decisions affecting their own lives, in those cases where they are sufficiently mature and able to understand the consequences of their decisions.

There is no overarching principle or “bright-line” test for when an underage person has reached the mature minor threshold.  It depends on numerous factors, the main one being whether the child or adolescent is adjudged to have the emotional and intellectual capacity and maturity to understand the nature and consequences of the decision.

What if the Parents Disagree?

In this context, it is irrelevant whether other family members – including his or her parents – disagree with the child’s decision.  For the most part, as long as the child meets the test for “mature minor” he or she is entitled to have their decision respected.  Yet there are some refinements and exceptions to this general principle.  In fact, the determination is very principled and nuanced.

Because the real question is not whether the parents disagree with the medical decision; rather, it’s whether a court disagrees, in those situations where the parents and child have had to come before it for resolution of their differences.

Will a Mature Minor’s Decision Always Be Upheld?

From the court’s perspective, if a child qualifies for and has been declared a mature minor, then there is a predisposition towards confirming his or her decision around medical care.  In other words, a mature minor’s decision will generally be upheld by a court, but that is subject to the following principles:

  • A mature minor is presumed to be making decisions that are in his or her own best interests.
  • A mature minor’s decisions are more likely to be respected and upheld where they align with the reasonable views of health care providers.
  • Conversely, a mature minor’s decisions might be scrutinized more closely by the court when they do not accord with what is broadly considered to be in their best interests, or where it contravenes the reasonable opinions of health care professionals. Likewise, in these scenarios the court may delve deeper into whether the mature minor’s has true decision-making capacity.
  • A child’s right to refuse to accept medical treatment may not be as strictly safeguarded as would be his or her decision to accept treatment, especially if the refusal might pose a risk to her or her life, health, and emotional/physical well-being.

In light of these principles, a court will never blindly defer to the wishes of a mature minor – even if his or her parents agree – in situations where those wishes would endanger the child’s health.  This is yet another complex assessment, and it involves considerations of the following factors:

  • The nature of the mature minor’s medical condition;
  • The nature of the proposed treatment;
  • Whether there are any family pressures that may impact his or her decision; and
  • The mature minor’s emotional and psychiatric condition.

In the next installment of this three-part Blog, we will take a closer look at when a court will actively override the decisions of a mature minor.  It’s an important concept, especially since the availability of the COVID-19 vaccine is expected to be broadened to the under-12 age group, in the very near future.


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About the author

Russell Alexander

Russell Alexander is the Founder & Senior Partner of Russell Alexander Collaborative Family Lawyers.