Ontario

Age of Majority: 18
Stipulated Age of Consent to Treatment in Legislation: None¹

Leading/Key Cases:

A.M. v C.H., 2019 ONCA 764

Law

Summary

Affirms the Supreme Court of Canada (SCC’)s stance in Manitoba (Director of Child & Family Services) v. C.(A.)

Relevant Paragraphs

[66] Having said that, Manitoba (Director of Child & Family Services) v. C. (A.), 2009 SCC 30, [2009] 2 S.C.R. 181 (S.C.C.) at paras. 81 and 82 highlighted the potential tension between a child's growing autonomy and the child's "best interests" norm …

[67] As a result, the majority in C. (A.)stated that the best interests standard "must be interpreted in a way that reflects and addresses an adolescent's evolving capacities for autonomous decision-making": at para. 88.

[68] Under this interpretation of the best interests standard, a minor's wishes will have greater weight as their maturity increases. In some cases, the court "will inevitably be so convinced of a child's maturity that the principles of welfare and autonomy will collapse altogether and the child's wishes will become the controlling factor": C. (A.), at para. 87. Scrutiny of a child's maturity will intensify in relation to the severity of potential consequences of medical treatment or its refusal: C. (A.)at paras. 95. This is partly because it is inherently difficult to assess an adolescent's ability to make medical decisions: C. (A.), at paras. 70-79.

Legislation

Health Care Consent Act, 1996, SO 1996, c 2, Sched A

Overall

•  No age cut-off is present in the legislation
  •  There is a presumption of capacity for all individuals, including minors, that is rebutted if the individual is demonstrably incapable of consenting

Text

s.4(2) A person is presumed to be capable with respect to treatment, admission to a care facility and personal assistance services.

Explanation

“In Ontario … all people – including children – are presumed capable of consenting to treatment. Age is not mentioned in the legislation. This presumption can be rebutted where a child or an adult is unable ‘to understand the information that is relevant to making a decision about treatment’”²

British Columbia

Age of Majority: 19
Stipulated Age of Consent to Treatment in Legislation: 19

Leading/Key Cases:

J.E.S.D. v Y.E.P, 2018 BCCA 286

Law

Summary

•  Affirms the SCC’s stance in C. (A.)
•  Emphasizes that a mature minor’s views will be an important consideration but not the determinative one

Relevant Paragraphs

[51] In Manitoba (Director of Child & Family Services) v. C. (A.), 2009 SCC 30 (S.C.C.), the Supreme Court of Canada considered the concept of "best interests of the child" in the context of legislation that permitted a court to authorize medical treatment, even against a child's wishes. Justice Abella, writing for the majority, noted that as children gain maturity, their wishes become proportionately more important in determining what is in their best interests …

[52] Inherent in the Court's analysis in C.(A.) is the recognition that circumstances will exist when the child's wishes do not conform to what is in his or her best interests . Children are sometimes incapable of identifying what is in their own best interests.

[53] While the views and wishes of a mature child … will be important in determining what is in her best interests, they will not be determinative .

R v E.Z.O, 2023 BCCA 122

Law

Summary

- Affirms the SCC’s stance in C. (A.)

Relevant Paragraphs

[24] Consistent with the concept of minority, there are limitations on the right of a minor to determine consent to treatment. Those limitations are defined in jurisprudence which holds that a minor may be capable of giving or refusing consent to medical treatment "if he or she has sufficient maturity, intelligence and capability of understanding what is involved in making informed choices about the proposed medical treatment": Van Mol v. Ashmore, 1999 BCCA 6; A.C. v. Manitoba (Director of Child and Family Services), 2009 SCC 30.The right of a minor to consent to health care is codified in the Infants Act, R.S.B.C. 1996, c. 223, s. 17, with the critical test being that the youth understands the nature and consequences and the reasonably foreseeable benefits and risks of the care. And so it is that in certain circumstances, a youth may be capable of deciding the issue of consent in respect of treatment. I will call this youth "the mature minor."

Legislation

Health Care (Consent) and Care Facility (Admission) Act, , RSBC 1996, c 181 (underline off)

Overall

•  All adults (anyone who is at least 19 years old) are presumed capable of consenting unless incapacity is proven

Text

s.4 Every adult [defined in this Act as at least 19 years old] who is capable of giving or refusing consent to health care has

1.  the right to give consent or to refuse consent on any grounds, including moral or religious grounds, even if the refusal will result in death,
2.  the right to select a particular form of available health care on any grounds, including moral or religious grounds,
3.  the right to revoke consent,
4.  the right to expect that a decision to give, refuse or revoke consent will be respected, and
5.  the right to be involved to the greatest degree possible in all case planning and decision making.

Infants Act, RSBC 1996, c 223

Overall

•  The legislation is in line with the SCC’s view in C. (A.) (and the common law’s “mature minor” doctrine)
  •  A minor’s consent constitutes valid consent in BC if the infant (a child under the age of 19) has demonstrated sufficient understanding of the nature and consequences of the proposed treatment (i.e., sufficient maturity) andif the treatment is found to be in the best interests of the minor

Text

s.17(2) Subject to subsection (3), an infant [who is defined in this Actas under 19 years of age] may consent to health carewhether or not that health care would, in the absence of consent, constitute a trespass to the infant's person, and if an infant provides that consent, the consent is effective and it is not necessary to obtain a consent to the health care from the infant's parent or guardian.

s.17(3) A request for or consent, agreement or acquiescence to health care by an infant does not constitute consent to the health care for the purposes of subsection (2) unless the health care provider providing the health care

1.  has explained to the infant and has been satisfied that the infant understands the nature and consequences and the reasonably foreseeable benefits and risks of the health care, and
2.  has made reasonable efforts to determine and has concluded that the health care is in the infant's best interests

Alberta

Age of Majority: 18
Stipulated Age of Consent to Treatment in Legislation: N/A³

Leading/Key Cases:

JI v Alberta,2023 ABCA 169

Law

Summary

•  Affirms the SCC’s stance in C. (A.)
  •  Emphasizes the fact that there is no bright line indicating sufficient maturity amongst adolescents

Relevant Paragraphs

[8] The common law recognizes that there is no bright line marking when minors become mature minors. The transition is a matter of degree , depending on the maturity of the teenager and the magnitude of the health decision to be made. While the common law recognizes that the wishes of the mature minor prima facierepresent his or her best interests, there is a residual jurisdiction in the Court to override his or her decision where life or health are endangered : A.C.at paras. 86-87.

[29]A.C.at para. 4 recognized the inherent imprecision in assessing an adolescent's maturity , and held at para. 21 that in order to be constitutionally compliant "best interests" of the child had to give sufficient account to the particular adolescent's maturity in any given medical treatment context …  While the adolescent's view would become "increasingly determinative" as one moved up the sliding scale, one could not state in the abstract when the teenager might have an effective veto …  The court always had a discretion in determining what medical treatment was in the best interests of the child, but that discretion became narrower and narrower as the maturity of the teenager increased …; A.C.at paras. 104-106, 108.

[30] A collateral consequence of the principle of autonomy confirmed in A.C.was that the teenager should always be given an opportunity to demonstrate to the court his or her maturity , relative to the particular medical context. Further, in each case the assessment of the maturity of the teenager requires an individualized assessment : A.C.at paras. 94-96.

[32] Like the Manitoba statute in A.C., the basis of any decisions under the Child, Youth and Family Enhancement Actis the best interests of the child. The Alberta Act also provides for consideration of the teenager's wishes, as well as his or her religious beliefs: supra, para. 20. In effect, mature minors under 16 in Manitoba and mature minors under 18 in Alberta are in the same position .

[34] … As the Supreme Court noted in A.C., there is no bright line marking when adolescents become sufficiently mature to make health care decisions. The statute is not constitutionally deficient because it does not attempt to define "maturity" or provide a bright line definition. 

[35] …  Each of the common law mature minor concept, the principles in A.C., and the requirements of s. 1.1(b) of the Act require that the wishes of the mature minor be taken into consideration . All three of them recognize that there will come a point where the adolescent's views become increasingly determinative such that the principles of welfare and autonomy collapse altogether and the adolescent's wishes become the controlling factor.

Legislation

Personal Directives Act,, RSA 2000, c P-6

•  Silent on minors’ consent rights (with respect to medical decision-making as opposed to providing a healthcare directive)
  •  Hence, the common law “mature minor” doctrine (endorsed by C. (A.)) applies⁴ to children under 18

Explanation

In Alberta, “a patient under the age of 18 years is presumed to be a minor patient without capacity … This presumption can be rebutted and the minor patient may be able to provide consent, if the minor patient is assessed and deemed a mature minor.”⁵

Saskatchewan

Age of Majority: 18
Stipulated Age of Consent to Treatment in Legislation: N/A

Leading/Key Cases:

O.M.S. v E.J.S., 2021 SKQB 243

Law

Summary

Affirms the SCC’s stance in C. (A.)

Relevant Paragraphs

[80] In considering the views of a minor when determining that which is in their best interests, I am required to consider what is described as the mature minor doctrine. The parties are agreed that this doctrine is best explained through the words of Abella J. in A.C. v Manitoba (Director of Child and Family Services), 2009 SCC 30, [2009] 2 SCR 181

Cates v Kendall, 2011 SKQB 225

Law

Summary

Affirms the SCC’s stance in Manitoba

Relevant Paragraphs

[45] The Abella decision in Manitoba (Director of Child & Family Services) v. C. (A.) , in addressing the law as it relates to children, holds that the general purpose of the "best interests" standard is to provide courts with a focus and perspective through which to act on behalf of those who are vulnerable. The common law has, however, recently abandoned the assumption that all minors lack decision-making capacity, and replaced it with a general recognition that children are entitled to a degree of autonomy reflective of their evolving intelligence and understanding . This is the common law "mature minor" doctrine . The doctrine strives to ensure that young people not be automatically deprived of the right to make decisions affecting their medical treatment. It provides instead that the right to make those decisions varies in accordance with the young person's level of maturity, with the degree to which maturity is scrutinized intensifying in accordance with the severity of the potential consequences of the treatment or of its refusal.

Legislation

Overall

•  No legislation exists that sets out minors’ consent rights with respect to health care decisions
  •  Hence, the common law “mature minor” doctrine (endorsed by C.(A.)) applies⁶ to children under 18

Health Care Directives and Substitute Health Care Decision Makers Act, 2015 , SS 205, c H-0.002

•  Silent on minors’ consent rights (with respect to medical decision-making as opposed to providing a healthcare directive)
  •  Hence, the common law “mature minor” doctrine (endorsed by Manitoba) applies⁷ to children under 18

Manitoba

Age of Majority: 18
Stipulated Age of Consent to Treatment in Legislation: 16

Leading/Key Cases:

Manitoba (Director of Child & Family Services) v C.(A.) , 2009 SCC 30

Law

Summary

•  16 and Over
  •  Presumption that the child’s interests are best advanced by abiding by his/her wishes
    •  i.e., have the right to consent unless proven incapable
•  Under 16
  •  No such presumption exists, however:
    •  If the child can demonstrate that he/she is capable of making a mature, independent decision for himself/herself, his/her stance must be heard, acknowledged, and weighed appropriately with respect to other factors such as the nature of the treatment and the severity of its potential consequences
      •  i.e., even if a child is under the age cut-off with respect to consent, he/she has the right to have/his her views heard
•  Overall Stance
  •  Minors under the age cut-off for presumed competence to consent – whatever that cut-off may be – have the right to be heard
    •   Common Law “Mature Minor” Doctrine: the higher the degree of their demonstrated maturity, the more their views should be considered/weighed

Relevant Paragraphs

[2] When a child under 16 is apprehended in Manitoba pursuant to the Child and Family Services Act, C.C.S.M. c. C80, and where the child or his or her parents refuse essential medical treatment, the court may authorize treatment that it considers to be "in the best interests" of the child .

[4] … in order to respect an adolescent's evolving right to autonomous medical decision-making , a thorough assessment of maturity, however difficult, is required in determining his or her best interests.

[21] … In my view, to be constitutionally compliant, the interpretation of "best interests" in s. 25(8) of the Act requires that sufficient account be taken of a particular adolescent's maturity in any given medical treatment context.

[22] It is a sliding scale of scrutiny , with the adolescent's views becoming increasingly determinative depending on his or her ability to exercise mature, independent judgment . The more serious the nature of the decision, and the more severe its potential impact on the life or health of the child, the greater the degree of scrutiny that will be required.

[24] Under the Child and Family Services Act, where either the child or the child's parents refuse to consent to recommended medical treatment, the court has the power under s. 25(8) to consider whether authorizing treatment against the wishes of the parents and/or child is in the child's best interests. Section 25(9) presumes that the best interests of a child 16 or over will be most effectively promoted by allowing the child's views to be determinative, unless it can be shown that the child lacks the maturity to understand the decision or appreciate its consequences. Where the child is under 16, no such presumption exists.

[87] The more a court is satisfied that a child is capable of making a mature, independent decision on his or her own behalf, the greater the weight that will be given to his or her views when a court is exercising its discretion under s. 25(8) …

[94] Scrutiny of a child's maturity in a s. 25(8) best interests analysis will require, by definition, an individualized assessment , having regard to the unique situation of the particular child, including the nature of the treatment decision and the severity of its potential consequences …

[96] … Yet the right of mature adolescents not to be unfairly deprived of their medical decision-making autonomy means that the assessment must be undertaken with respect and rigour. The following factors may be of assistance:

•  What is the nature, purpose and utility of the recommended medical treatment? What are the risks and benefits?
•  Does the adolescent demonstrate the intellectual capacity and sophistication to understand the information relevant to making the decision and to appreciate the potential consequences?
•  Is there reason to believe that the adolescent's views are stable and a true reflection of his or her core values and beliefs?
•  What is the potential impact of the adolescent's lifestyle, family relationships and broader social affiliations on his or her ability to exercise independent judgment?
•  Are there any existing emotional or psychiatric vulnerabilities?
•  Does the adolescent's illness or condition have an impact on his or her decision-making ability?
•  Is there any relevant information from adults who know the adolescent, like teachers or doctors?

Legislation

The Health Care Directives Act,, SM 1992, c 33

Overall

•  16 and Over
  •  Presumed capable of consenting
•  Under 16
  •  No such presumption
    •  However, this presumption can be rebutted by demonstrating capacity (maturity)

Text

s.4(2) In the absence of evidence to the contrary , it shall be presumed for the purpose of this Act

1.  that a person who is 16 years of age or more has the capacity to make health care decisions; and
2.  that a person who is under 16 years of age does not have the capacity to make health care decisions.

Québec

Age of Majority: 18
Stipulated Age of Consent to Treatment in Legislation: 14

Legislation

Civil Code of Québec, , SQ 1991, c 64

Overall

•  14 and Over
  •  Presumed capable of consenting
•  Under 14
  •  Presumed incapable of consenting
    •  However, the child’s views must still be heard, if he/she is deemed to be sufficiently mature (in line with Manitoba )

Text

s.17 A minor 14 years of age or over may give his consent alone to care not required by the state of his health; however, the consent of the person having parental authority or of the tutor is required if the care entails a serious risk for the health of the minor and may cause him grave and permanent effects.

s.18 Where the person is under 14 years of age or is incapable of giving his consent, consent to care not required by his state of health is given by the person having parental authority or the mandatary or tutor ; the authorization of the court is also necessary if the care entails a serious risk to health or if it may cause grave and permanent effects.

Explanation

In Quebec, “children under the age of 14 aren’t allowed to make health-related decisions on their own. The consent of their parents or a guardian (officially called a “tutor”) is always needed, whether or not the care is essential for the child’s health. For a child under the age of 14, the parents or tutor have full responsibility for all health care decisions.”⁸

However, “the child’s opinion must be considered as much as possible. If a judge has to make a decision about health care for a child under 14, the judge must hear what the child has to say , as long as the child’s age and level of understandingallow the child to participate in the decision ”⁹ (i.e., as long as the child is sufficiently mature to speak to the matter at hand)

Newfoundland and Labrador

Age of Majority: 19
Stipulated Age of Consent to Treatment in Legislation: 16

Leading/Key Cases:

H. (P.) v. Eastern Regional Integrated Health Authority , 2010 NLTD 34

Law

Summary

Affirms the SCC’s stance in C. (A.)

Relevant Paragraphs

[32] In this Province, by way of legislation, including the Advance Health Care Directives Act, S.N.L. 1995, c. A-4.1 (section 7), the Child, Youth and Family Services Act , S.N.L. 1998, c. C-12.1, and the Neglected Adults Welfare Act , R.S.N.L. 1990, c. N-3, a person who attains the age of 16 is presumed competent to consent to their own medical treatment. This legislation is subject to the common law recognition of the "mature minor" doctrine . This doctrine recognizes that persons under the age of 16 who are found to be "mature minors" are able to make their own health care decisions. Such persons have the right to make such decisions based upon their level of maturity. The scrutinizing of that maturity is said to increase in accordance with the severity of potential consequences of the treatment or refusal to accept treatment (see Manitoba (Director of Child & Family Services) v. C. (A.), C. (J.S.) v. Wren (1986), 76 A.R. 118 (Alta. Q.B.), and Y. (A.), Re (1993), 111 Nfld. & P.E.I.R. 91 (Nfld. U.F.C.)).

[46] In [Manitoba], Abella, J., for the majority of the court, found that, in accordance with the Child and Family Services Act , C.C.S.M. c. C80, applicable child protection legislation in place in Manitoba that stipulated that a court could authorize medical treatment for a person under 16 years of age considered in that person's best interests , such a consideration was not an unconstitutional one. The caveat to this is that the best interests standard must be applied in a manner that takes into increasingly serious account the young person's views the greater the child's level of maturity . This is an analysis that is best analogized with a "sliding scale" type of approach. While this reasoning was applied with regard to a person under of the age of 16, I find that the same reasoning is applicable to those over the age of 16 up to the time the person reaches the age of majority and is recognized by law as an adult.

K., Re, 2010 NLUFC 6

Law

Summary

•  Affirms the SCC’s stance in C. (A.)
  •  Applies the SCC’s stance in interpreting its legislation Child, Youth and Family Services Act )

Relevant Paragraphs

[32] In this Province, by way of legislation, including the Advance Health Care Directives Act, S.N.L. 1995, c. A-4.1 (section 7), the Child, Youth and Family Services Act, S.N.L. 1998, c. C-12.1, and the Neglected Adults Welfare Act, R.S.N.L. 1990, c. N-3, a person who attains the age of 16 is presumed competent to consent to their own medical treatment. This legislation is subject to the common law recognition of the "mature minor" doctrine . This doctrine recognizes that persons under the age of 16 who are found to be "mature minors" are able to make their own health care decisions. Such persons have the right to make such decisions based upon their level of maturity. The scrutinizing of that maturity is said to increase in accordance with the severity of potential consequences of the treatment or refusal to accept treatment (see A.C. v. Manitoba(Director of Child and Family Services, C.(J.S.) v. Wren (1986), 76 A.R. 45 (C.A.), and Re A.Y. (1993), 111 Nfld. & P.E.I.R. 91 (Nfld. U.F.C.)).

[34] At age 15 and a half, "this standard must be applied in line with the level of maturity had by the individual involved as well as the independence of their judgment" (see H. (P.)at p. 45 citing Manitoba (Director of Child & Family Services) v. C. (A.), [2009] S.C.J. No. 30 (S.C.C.))

Legislation

Advance Health Care Directives Act,, SN 1995, c A-4.1

Overall

•  Over 16
  •  Presumed capable of consenting to health care decisions
•  Under 16
  •  No such presumption
    •  However, this presumption can be rebutted by demonstrating capacity (maturity)

Text

s.7 For the purpose of this section, there shall, in the absence of evidence to the contrary , be a presumption

1.  that an advance health care directive was made immediately prior to the maker losing the competency to make health care decisions;
2.  that a person who is 16 years of age or older is competent to make health care decisions; and
3.  that a person who is younger than 16 years of age is not competent to make health care decisions.

Explanation

“A person under 16 years may make a [healthcare] directive, if assessed as a mature minor , which is a person under the age of 16 who understands his/her health issues and wishes to make his/her own decisions.”¹⁰

New Brunswick

Age of Majority: 19
Stipulated Age of Consent to Treatment in Legislation: 16

Leading/Key Cases:

S.H. v Minister of Social Development and C. H., 2021 NBCA 56

Law

Summary

• Affirms the SCC’s stance in C. (A.)
  • Albeit in the context of child custody matters

Relevant Paragraphs

[32]  … in A. C. v Manitoba (Director of Child and Family Services) , the Supreme Court acknowledged there is a compelling argument that children of sufficient maturity have a constitutional right to have their views put before the court, by reason of the fact their "liberty and security" of the person is affected. The Act specifically refers to the views and preferences of children as one criterion to be considered in a child custody dispute; however, they are not determinative.

Legislation

Medical Consent of Minors Act, , SNB 1976, c M-6.1

Overall

• The legislation is in line with the SCC’s view in Manitoba(and the common law’s “mature minor” doctrine)
  •  A minor’s consent constitutes valid consent in New Brunswick if he/she has demonstrated sufficient understanding of the nature and consequences of the proposed treatment (i.e., sufficient maturity) andif the treatment is found to be in the best interests of the minor
• 16 and Over
  •  Presumed capable of consenting to health care decisions
•  Under 16
  •  No such presumption
    •  However, this presumption can be rebutted by demonstrating capacity (maturity)

Text

s.3(1) The consent to medical treatment of a minor who has not attained the age of sixteen years is as effective as it would be if he had attained the age of majority where, in the opinion of a legally qualified medical practitioner, dentist, nurse practitioner, midwife or nurse attending the minor,

1.  the minor is capable of understanding the nature and consequences of the medical treatment, and
2.  the medical treatment and the procedure to be used is in the best interests of the minor and his continuing health and well-being.

Nova Scotia

Age of Majority: 19
Stipulated Age of Consent to Treatment in Legislation: N/A

Leading/Key Cases:

O. (S.E.) v W. (J.), 2013 NFSC 15

Law

Summary

Applies C.(A.)in the case of a 13-year-old’s custody matter

Relevant Paragraphs

[25] The child Rhianna has been with her father full time since March, 2013 and between 2006 and that time Monday after school to Thursday morning. The rest of the time with the Respondent mother until she moved to Alberta in March of 2013. Rhianna wants to stay with her father and his partner F.M.V. She is happy there in a stable environment and has a very good relationship with F.M.V. She has been described as extremely capable of expressing her residential wishes. There is no evidence she was unduly influenced to side in favour of living with her father. She is mature enough to understand proceedings and form an independent opinion to the assessor (see Manitoba (Director of Child & Family Services) v. C. (A.), 2009 SCC 30 (S.C.C.))

Legislation

Overall

•  No legislation exists that sets out minors’ consent rights with respect to health care decisions
  •  Hence, the common law “mature minor” doctrine (endorsed by Manitoba) applies¹¹ to children under 19

Personal Directives Act, SNS 2008, c 8  

•  Silent on minors’ consent rights with respect to health care decisions
  •  Hence, the common law “mature minor” doctrine (endorsed by Manitoba) applies¹² to children under 19

Explanation

“In Nova Scotia the age of majority is 19 years old. Any person under this age is considered a minor. However, there is no law that grants or denies any decision-making entitlement to minors; therefore, if they are able to understand the risks and benefits , they are legally entitled to make decisions regarding their own health care.”¹³

Prince Edward Island

Age of Majority: 18
Stipulated Age of Consent to Treatment in Legislation: None

Legislation

Consent to Treatment and Health Care Directives Act,, SPEI 1996, c 10 (No underline)

Overall

•  No age cut-off is present in the legislation
  •  There is a presumption of capacity for all individuals, including minors, that is rebutted if the individual is demonstrably incapable of consenting

Text

s.4 Every patient who is capable of giving or refusing consent to treatment has the right

1.  to give consent or to refuse consent on any grounds, including moral or religious grounds, even if the refusal will result in death;
2.  to select a particular form of treatment from among those proposed by a health practitioner on any grounds, including moral or religious grounds;
3.  to be assisted by an associate; and
4.  to be involved to the greatest degree practicable in case planning and decision making.

Explanation

“In … Prince Edward Island … all people – including children – are presumed capable of consenting to treatment. Age is not mentioned in the legislation. This presumption can be rebutted where a child or an adult is unable ‘to understand the information that is relevant to making a decision about treatment’”¹⁴

“The law [in PEI] doesn’t give an age limit for you to give or refuse consent to treatment. Doctors or other medical people may feel you are mature enough to discuss treatments with you without your parents present.”¹⁵

Northwest Territories

Age of Majority: 19
Stipulated Age of Consent to Treatment in Legislation: N/A

Legislation

Overall

•  No legislation exists that sets out minors’ consent rights with respect to health care decisions
  •  Hence, the common law “mature minor” doctrine (endorsed by C.(A.)) applies¹⁶ to children under 19

Personal Directives Act, SNWT 2005, c 16

•  Silent on minors’ consent rights (with respect to medical decision-making as opposed to providing a healthcare directive)
  •  Hence, the common law “mature minor” doctrine (endorsed by Manitoba) applies¹⁷ to children under 19

Yukon

Age of Majority: 19
Stipulated Age of Consent to Treatment in Legislation: None

Legislation

Care Consent Act, , SY 2003, c 21, Sched B

Overall

•  No age cut-off is present in the legislation
  •  There is a presumption of capacity for all individuals, including minors, that is rebutted if the individual is demonstrably incapable of consenting

Text

s.3 Every person who is capable of giving or refusing consent to care has

1.  the right to give consent or to refuse consent on any grounds, including moral or religious grounds, even if the refusal will result in death;
2.  the right to select a particular form of available care on any grounds, including moral or religious grounds; and
3.  the right to revoke consent

Explanation

“In … the Yukon, all people – including children are presumed capable of consenting to treatment. Age is not mentioned in the legislation. This presumption can be rebutted where a child or an adult is unable ‘to understand the information that is relevant to making a decision about treatment.”¹⁸

“There is no legal age of consent for health care in Yukon. That means that a child can consent or revoke to the vaccine on their own behalf if the nurse has determined that the child is capable of making this decision based on professional guidelines in place.”¹⁹

Nunavut

Age of Majority: 19
Stipulated Age of Consent to Treatment in Legislation: 19

Legislation

Overall

•  No legislation exists that sets out minors’ consent rights with respect to health care decisions
  •  Hence, the common law “mature minor” doctrine (endorsed by C. (A.)) applies²⁰ to children under 19
•  However, a Nunavut Immunization Manual from 2014²¹ outlines that:
  •  19 and Over
    •  Presumed capable of consenting
  •  Under 19
    •  Presumed incapable of consenting
      •  However, this presumption can be rebutted by demonstrating capacity (maturity)

Explanation (Nunavut Immunization Manual)

“In Nunavut, all adults (over the age of majority, which in Nunavut is 19 years) are presumed to be capable of consenting or withholding consent unless the practitioner has reason to believe the adult lacks capacity. Unlike adults, most minors (under 19 years of age) are presumed to be incapable of consenting on their own behalf. Instead, the child’s parent or legal guardian consents on their behalf … The common law also recognizes a category of minor called the “mature minor. ” A mature minor is typically between the ages of 15-18 years and has the necessary capacity to fully understand the consequences of treatment or refusing treatment. Mature minor status is always decided on a case-by-case basis and requires a judgment call by

the immunization provider. A mature minor can override the medical decisions made by his/her parentsand can either give consent or refuse immunizations.

“²²

Important Consideration

“All provinces, with the exception of Nova Scotia, the Northwest Territories, and Nunavut, have legislation addressing, globally, consent to medical treatment.”²³