A survey of the legal frameworks on medical decision-making in minors in European countries.

This study examines how healthcare decisions involving minors are handled across European countries by asking member organizations of the European Academy of Paediatrics (EAP). An online survey was distributed via the EAP network to representatives of national paediatric associations in all European countries. The survey focused on determining the age at which minors can consent to medical treatment without parental permission, including contexts such as mental health treatment, reproductive health, vaccinations, life-threatening situations, and end-of-life decisions. Responses were collected, analysed, and validated through follow-up checks with the respondents. We received 62 responses from 43 countries. The minimum age at which minors can consent to medical treatment varies substantially across Europe, ranging from sixteen or eighteen years in some countries to being based on the child's maturity in others. Additionally, there are disparities in the age of consent across specific contexts; for example, end-of-life decisions for minors are prohibited in several countries.Conclusions: In 2024, substantial differences persist in the legal age at which minors can make healthcare decisions across Europe. These findings are pertinent for policymakers and healthcare providers aiming to develop regulations that uphold the rights of young people while ensuring ethical, patient-centered care in a diverse continent but with easy movement and migration across internal borders. Future research should investigate how European health systems adapt to changes in healthcare requirements as a child grows and matures, and the impact of EU policies on paediatric healthcare services. What is Known? • Prior research has established that the age at which minors can consent to medical treatment varies internationally. •Across European countries, legal ages for minor consent to medical treatment continue to show substantial variance, reflecting differing national policies and cultural attitudes towards the autonomy of young individuals. What is New? •This study uniquely highlights that not only does the age of consent differ across countries. • The age of consent varies across different medical contexts, such as mental health, reproductive health, and end-of-life decisions.