Minors’ right to choose whether to vaccinate raises questions

Although in South Africa, a child is characterised as someone who is under the age of 18, some provisions have been made over the years to empower minors to make decisions on their own.

The latest of these is that children aged 12 to 17 can decide to get a Covid-19 vaccine without a parent’s consent as announced by Health Minister Joe Phaahla last week.

Clinical psychologist Sibongile Sibanyoni says children between those ages are predominantly concerned about experimenting and exploring the different identities that will ultimately shape an integrated self.

This developmental stage is marked by the initiation of identity development which, according to Sibanyoni, is a lifelong process.

“From a cognitive-developmental perspective, minors at this age are able to think in a logical and abstract manner, meaning that they are able to think through the consequences of a particular decision that they may be thinking about.

“Therefore, they typically have the ability to plan and reason about the possible outcomes of a particular decision,” she said, adding that one needs to consider the minor’s maturity and mental capacity to understand the benefits, risks, and other implications of the vaccine.

“From a cognitive-developmental perspective, minors between the ages of 12 and 17 should be equipped with the ability to reason about the implication of the vaccine on their health, which can then inform the decision that they make, and that is where parents come in.

“Parents are not necessarily removed from the decision-making process because they are expected to have conversations with their minors about sensitive topics such as sex and abortion. By the time that the minor is confronted with the expectation to make a decision for themselves, it would be great if their decisions can be informed by their parents as well as other reputable sources of knowledge.

“From the Children’s Act 38 of 2005’s perspective, the healthcare needs of a minor need to be prioritised at all times failing which it may lead to a case of negligence against the parents.

“With the topic at hand, parents are encouraged to equip minors with all the necessary information regarding the vaccination process as well as the benefits of getting a vaccine.”

But for parents such as Bongani Mdlalose (36) and another Lerato Morake (35), they say this decision by the minister feels like the government came into their homes, and snatched their parenting rights away from them.

Mdlalose, a father to a 15-year-old Grade 9 pupil, says he isn’t at all against the vaccine, as he is vaccinated too, but would appreciate his consent to be required throughout this process.

“My biggest concern is what if my daughter doesn’t inform me, because I tell you now her head is filled with so many irrelevant things (which are normal at her age) or she is just afraid to let us know, and then she gets ill. What then?

“We are being placed in a precarious situation as parents all the time by the government. First, we can’t discipline our own children because we fear being jailed, now we can’t consent over what happens to them in terms of health. Next thing we will be told to renounce our parental rights altogether. What kind of households would we manage?” said the concerned father.

Morake’s 13-year-old daughter is in Grade 7 and says she will never stop telling her daughter what she thinks is right for her.

“I, myself, haven’t even taken the jab as I am still researching so that I can make an informed decision for my family. The vaccine is not 100% approved, it is still in its trial phase and as a parent, I need to be consulted for such a decision.

“I feel that because the government isn’t hitting its target numbers, they are cornering children so they can secure whatever numbers that will make them look efficient in the eyes of WHO (World Health Organization) and the likes. But while that happens, they are dismantling family structures without care,” she said.

According to Professor Pitika Ntuli, a historian and culture commentator, culturally the role of a parent is an authority figure there to protect the child, “and the vaccination is the ultimate protection”.

“With the many conspiracy theories that we are fed, kids are susceptible to listening to these and believing them. And that is where parents are needed, to help children filter the noise to make informed decisions together.

Ntuli believes that no one can exclude parents from this conversation or decision.

“The silence of maybe either the government or whatever authority that seems to not involve parents, needs to partner up with parents when it comes to this matter.

“Children who are 10, 11, or 12 right up to 16 are still minors and can’t make these decisions on their own. Leaving it simply for them to make up that decision excludes the parent’s role that we have grown to know, and we end up losing the generation of young people,” he said, adding that culture recognises a parent’s role to act in the best interest of a child.

“And if a parent doesn’t, there are ways to challenge that particular individual into keeping the child’s needs and what is right for them at the centre of the conversation. But how things are done now is outside of what family structures stand for,” he said.

What the law says:

Section 12 of the Constitution says everyone has a “‘right to bodily and psychological integrity”, including the right to make decisions concerning medical treatment and the right not to be subjected to medical procedures or scientific experiments without their informed consent.

The Children's Act (s129) states that children can consent to their own medical treatment, including vaccination, if:

(a) the child is over the age of 12 years; and

(b) the child is of sufficient maturity and has the mental capacity to understand the benefits, risks, social and other implications of the treatment.

Children can give sexual consent at the age of 16, and if they are between the ages of 12 - 16, they can consent to engage with another within that age group or two years older. But any sexual activity with a child under 12 years old is counted as statutory rape or sexual assault.

The Choice on Termination of Pregnancy Act 1 (Choice Act) states that females of any age can consent to a termination of pregnancy. The Children’s Act states that children who are of 12 years of age or over, and who are of sufficient maturity and have the mental capacity to understand the benefits, risks, social and other implications of medical treatment, may consent to such treatment without assistance from their parents or guardians. Children of 12 years of age or over, and of sufficient maturity, will be able to consent to surgical operations if they are assisted by their parents or guardians.