I mentioned that I had an interview for medical school a couple of weeks ago, a large part of my interview was on empathy, which led us to discuss consent and competence. It’s a large part of medicine so I wanted to write about what I’ve learnt from reading my medical interview book and from articles on the internet (like this: http://student.bmj.com/student/view-article.html?id=sbmj.g1455).
First of all, adults are assumed to be competent unless proven otherwise (e.g. if a mental illness has impaired the patients ability to understand the information given to them, and weigh up pros and cons). If an adult patient is not competent then no one else can give consent for them, doctors must act in the patients best interests and use any advanced directives written by the patient.
Similarly, 16 and 17 year olds are presumed to be competent for most procedures, but cannot refuse treatment unless supported by a parent or doctor.
Young children can be competent to make decisions about certain procedures, providing they are mature enough to understand the information given to them. A doctor has to involve a parent if the child is not thought to be competent.
EDIT: I updated the part on mental illness affecting ability to consent following a comment written below. The comment had a good definition of what it means to be competent, which is something I failed to mention: “To be competent, you have to be able to understand information given to you, weigh up the pros and cons, and communicate your decision.”