The Mental Capacity Act 2005 and mature minors: a missed opportunity?

English law ostensibly offers significant respect for personal autonomy in medical decision-making. However, in relation to some patients who make unwise decisions, or who have difficulty in understanding and engaging with information when presented in the traditional manner, the courts have interfered with autonomy by making doubtful findings of incapacity. The Mental Capacity Act 2005 (MCA) seeks to prevent interference with autonomy on the basis of such dubious findings of incapacity with respect to those aged over 16. It is argued here that, in the light of increasing evidence of children's abilities and the trajectory of children's interests, the failure to extend this protection to mature minors under the age of 16 is a missed opportunity.