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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.

This paper challenges historically preconceived notions surrounding a minor’s ability to make medical decisions, arguing that federal health law should be reformed to allow minors with capacity as young as age 12 to consent to their own Centers for Diseases Control and Prevention (CDC)-approved COVID-19 vaccinations. This proposal aligns with and expands upon current exceptions to limitations on adolescent decision-making. This analysis reviews the historic and current anti-vaccination sentiment, examines legal precedence and rationale, outlines supporting ethical arguments regarding adolescent decision-making, and offers rebuttals to anticipated ethical counterarguments.

Regulations are vague regarding the appropriate decision-maker and authority to consent for children of minor parents participating in clinical trials. In countries with high rates of underage mothers, such as in sub-Saharan Africa, this lack of guidance may affect the rights of potential paediatric participants already bearing increased vulnerability. It can also influence the recruitment and generalizability of the research. We provide evidence and discuss informed consent management in such cases to inform best practice. We searched PubMed/MEDLINE, Embase, CINAHL, and Google Scholar for articles published up to March 2019. In total, 4382 articles were screened, of which 16 met our inclusion criteria. Studies addressing informed consent in clinical trials involving children with minor parents in sub-Saharan Africa were included. We performed descriptive and qualitative framework analyses. The review was registered in PROSPERO: CRD42018074220. Various informed consent approaches were reported. Articles supporting individual consent by minor parents based on emancipation or \"mature minor\" status lacked evidence in the context of research. National laws on medical care guided consent instead. When no laws or guidance existed an interpretation of the local decision-making culture, including community engagement and collaboration with local ethics committees, defined the informed consent approach. The review emphasises that the implementation of informed consent for children with minor parents may be variable and hampered by absent or ambiguous clinical trial regulations, as well as divergent local realities. It may further be influenced by the research area and study-specific risks. Clear guidance is required to help address these challenges proactively in clinical trial planning. We provided a set of questions to be considered in the development of an ethically acceptable informed consent approach and proposed information that should be integrated into international clinical trial guidelines.

Policies allowing some minors to consent to receive recommended vaccines are ethically defensible. However, a policy change at the federal level expanding minor consent for vaccinations nationwide risks triggering a political backlash. Such a move may be perceived as infringing on the rights of parents to make decisions about their children’s health care. In the current post-COVID environment of heightened anti-vaccination activism, changes to minor consent laws may be unadvisable, and policy makers should proceed with caution.

ObjectivesTo examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications.DesignThis was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival.SettingInitially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway.ParticipantsMale UM from Afghanistan, Somalia, Algeria and Iran.Main outcome measuresMental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire.ResultsAt the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress.ConclusionMental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum.

Parents’ resistance to vaccination is leaving more children vulnerable to measles and other preventable illnesses. Most states, however, don’t authorize adolescents to independently consent to vaccination.

Low Covid-19 vaccination rates among U.S. adolescents can be partly explained by some parents’ decision not to consent to vaccination for their children. More states could allow adolescents to independently consent to vaccination, even when their parents are opposed.

Background: In 2024, Poland introduced a ban on the sale of energy drinks to individuals under 18 years of age. The aim of this study was to assess energy drink consumption among adolescents aged 12–17 years and to evaluate the effectiveness of this regulation. Methods: This cross-sectional study was conducted in 2025, using an anonymous questionnaire. A total of 1691 students from primary and secondary schools, living in both urban and rural areas, participated. Results: Consumption of energy drinks in the month preceding the survey was reported by 41.1% of students, with the likelihood of consumption increasing by nearly 50% with each additional year of age (OR = 1.496; 95% CI: 1.381–1.621; p < 0.001). Secondary school students reported significantly higher consumption compared with primary school students (47.1% vs. 21.6%; p < 0.001). The median consumption frequency was 1–2 times per month among primary school students and 1–2 times per week among secondary school students. More than half of adolescents (58.1%) stated that the sales ban did not restrict their access to energy drinks, with adult-mediated purchases being the most common source. Among those attempting direct purchases in physical shops, only 19.3% were consistently asked to provide proof of age. Over half of the respondents did not believe that energy drinks can be harmful to their health; these students reported consumption more than twice as often as students who regarded them as harmful (54.0% vs. 23.9%; p < 0.001). Conclusions: These findings suggest that, to date, the ban on energy drink sales to minors in Poland has had a limited impact on adolescent consumption, highlighting the need for enhanced educational initiatives in this area. However, the study was cross-sectional in nature and was not conducted on a nationally representative sample of adolescents, which should be taken into account when interpreting the results.

Implications A debate on the adoption of a tobacco age-of-sale of 21 in Europe has not occurred, with the recent exception of the United Kingdom. The current legally set age of 18 years is proving to be inadequate as adolescents continue to access cigarettes. Tobacco 21 laws have the potential to further limit access to cigarettes by minors. We believe that soon the time will be ripe for this discussion to spread throughout Europe, specifically among countries that have adopted a smoke-free generation movement.

To examine the impact of enforcement of age-restricted tobacco sales on adolescent tobacco purchasing and smoking, we compared the Central Coast intervention area to the rest of New South Wales (NSW) and Australia. We collected data on students in school years 7-12 from triennial health surveys at baseline in 1993 through 2002. Attempts by minors to purchase tobacco in the intervention area declined by 73.6 per cent between 1993 and 2002. Between 1993 and 1996 the prevalence of smoking declined in the Central Coast intervention area, while remaining unchanged in NSW as a whole and nationally (P<0.0001). Between 1993 and 2002, the prevalence of current smoking in the intervention area was reduced by half. Effective enforcement of an age-restricted tobacco sales law was accompanied by a substantial reduction in attempted purchases of tobacco and of smoking by youth. The long-term follow-up in this study allows us to observe that the impact of the intervention was not only sustained but also increased with time.