Adolescence and Child Rights
Adolescence is a period of significant physical, emotional, and cognitive change. The development of independence from family and the pressure to conform to peers can impose challenges in the management of chronic disease. However, adolescents with chronic illnesses require more support from family and caregivers. Adolescence spans the period of pubertal development, which manifests with physical
Adolescence is a period of significant physical, emotional, and cognitive change. The development of independence from family and the pressure to conform to peers can impose challenges in the management of chronic disease. However, adolescents with chronic illnesses require more support from family and caregivers.
Adolescence spans the period of pubertal development, which manifests with physical changes which reflect maturation of the gonads and hypothalamic-pituitary-gonadal axis. The generally accepted age for adolescence includes 10 to 19 years, but the adolescent/youth period may extend to 24 years. Irresponsible behaviour and a tendency towards risk-taking are features in adolescence that are related to the hormonal changes in puberty.
Distinct psychosocial features characterise early, mid- and late adolescence; these stages affect adherence. In early adolescence, the individual is unable to think abstractly or plan ahead; in middle adolescence, concrete thinking in times of stress develops; in late adolescence, abstract thinking and the ability to anticipate the future and plan develops.
CHILD RIGHTS (Children's ACT 38 of 2005)
https://www.gov.za/documents/childrens-act
A child is defined by the Bill of Rights and the Children’s Act as “a person under the age of 18 years”.1
Access to information and confidentiality
Every child has a right to access to information and confidentiality regarding his/her health status and treatment, except when this confidentiality is not in the best interests of the child. Consent to disclose that a child is HIV positive may be given by the child if (s)he is 12 years or older, or of sufficient maturity to understand the implications of such disclosure. In younger children, the consent may be given by the parent/caregiver, or person in charge of a hospital (if the child is hospitalised).
Consent to medical and surgical treatment
A child may consent to his/her own medical treatment and surgical operation if (s)he is over 12 years and has the mental capacity to understand the implications of the treatment/procedure. For a surgical operation the child must be duly assisted by his/her parent or guardian. The person in charge of a hospital may consent to the medical treatment or surgical operation if this is necessary to save the life of the child or save the child from serious injury or disability or if the need for the operation is urgent.
Contraceptives
Condoms may not be withheld from children older than 12 years if they request them. Contraceptives other than condoms may be given to children older than 12 years without the consent of the parent/guardian provided that proper medical counselling has been given to the child and that the child has been examined to exclude contraindications to giving specific contraceptives.
Termination of pregnancy (Choice on Termination of Pregnancy Act 92 of 1996)
If a pregnant minor requests termination of pregnancy she should be advised to discuss it with her parents/guardians but their consent is not required.
Sexual assault [Criminal law (Sexual Offenses and Related Matters) Act 32 of 2007]
While a person younger than 18 years is considered a child in South Africa, the act does allow consensual sex for people who are between 16 and 18 years. It is illegal for any person younger than 16 years to consent to or to be involved in any sexual act. It should be noted that consensual sex where both parties are 12 to 15 years is no longer a sexual offence. Consensual sex between an adolescent younger than 16 years and a partner who is not more than 2 years older is legal.
A healthcare worker may prescribe contraception to children under the age of 16 years without obtaining parental/caregiver consent.
Healthcare workers are reminded of their obligation to report sexual assault.
Refer to Sexual Offenses and Related Matters Act 32 of 2007 and the Constitutional Court ruling Case CCT [2013] ZACC 35 for further guidance.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 24: Adolescence