Note: The following article was written in 2021 and does not reflect announcements/changes that have transpired since then.
Since resuming in-person education, a spotlight has shined brightly on Ontario youth and efforts towards limiting COVID-19 transmission in schools. Following the adult vaccination roll out, youth ages twelve and up were given the green light to receive mRNA vaccines in May 2021 while the province is currently in the process of finalizing a vaccine plan for children ages five to eleven. However, parents and legal guardians may be surprised to learn that youth in the province do not need parental consent to receive their vaccine.
A common misconception among the general public is that in order for a child to receive medical treatment, parents and guardians would have to provide health care consent on behalf of their child. While this may be a widespread belief, provincial legislation says otherwise. Under Ontario’s Health Care Consent Act, there is no minimum age of consent for individual capacity to make decisions pertaining to medical treatment decisions. Without an age benchmark, Ontario’s children have autonomy over their own health decisions unless a doctor deems them incapable. The notion of incapacity can be read into ordinarily, purposing that mental incompetency verified by a doctor would not allow for individuals to make their own health decisions. As a result, other options remain available, such as a person’s substitute decision-maker giving consent on the person’s behalf. Dr. Charles Gardner, medical officer of health for the Simcoe Muskoka District Health Unit, frames health care consent in Ontario simply: “age is actually not a requirement; it’s the ability to understand that’s the requirement.”
This means that as of current, and absent of incapability, youth aged twelve and up can consent to receiving COVID-19 vaccinations provided that they are aware of the risks and benefits to their decision—this awareness is referred to as “informed consent.” The requirement of informed consent has the potential to create a grey area for guardians of youth under the age of seventeen, ultimately leading Ontarians to ask, “what constitutes informed consent?”
Taken from the Child and Youth COVID-19 fact sheet from the province’s website, informed consent “means understanding the treatment, why it is being recommended, and the risks and benefits if they accept or refuse to be vaccinated.” While these standards appear concise, analyzing whether informed consent is an adequate requirement for youth receiving the COVID-19 vaccination can be determined using an answer in which law students are very familiar with, the answer being, “it depends.” Since Health Canada authorized mRNA COVID-19 vaccines for youth aged twelve and older, parents and experts have come forward voicing opinions around the widely overlooked no minimum age requirement for health decisions. The argument that parental or guardian consent should be required is an expected one. Peer pressure and rabbit holes of misinformation on social media could influence youth to do things they would not otherwise do—we have all been there. However, choosing whether or not to receive a COVID-19 vaccine is arguably more serious than being influenced on what music to listen to or which clothes to wear: Vaccination is a significant life decision. Given the subjectiveness of making the “right” decision, it is of no surprise that parents and guardians would feel as though such a complex decision should require their consent. On the other side of this, the legislation providing youth with the autonomy for their own medical consent is, in its full form, instated by the province to protect the human rights of the young and the elderly to maintain control over their bodies. Regardless of an individual’s decision, the mere allocation for individuals to make their own health care choices purports to guide human behavior in our province. The provided autonomy is simply the nature of this legislation.
As the COVID-19 pandemic continues to prevail, some adults in Ontario are now eligible for a third COVID-19 vaccine, also known as a “booster dose.” While adults have likely assumed their age as a rite of passage to decide their immunization status, it is important for all Ontarians to know their rights pertaining to medical treatment decisions, specifically, decisions regarding COVID-19 vaccinations. While being considered a child in Ontario sustains immense constraints and restrictions pertaining to what a child can and cannot do, Ontario’s Health Care Consent Act gives youth a taste of autonomy prior to adulthood.