Contradictions in concepts of children's rights

This paper discusses contradictions within concepts of children's competence or capacity to consent, with examples drawn from research on children's consent to surgery. Competence entails understanding and wisdom. Yet definitions of understanding as esoteric abstract professional expertise conflict with the kinds of profound understanding some sick children have, drawn from their experience, thought and feeling. `Wisdom' combines Kantian reason which discerns the correct decision with Millean maturity which accepts responsibility for freely made decisions, even if these are mistaken; concepts of a correct choice conflict with those of a best guess. Beliefs about children's inevitable immaturity are contradicted by the demonstrated maturity of certain young children. Children's rights to resources and to protection can contradict yet complement their autonomy rights. When children are assumed to be incompetent, `children's autonomy rights', which depend on demonstrable competence, is a contradiction in terms. Adults' interests and their notions of children's welfare and interests can conflict with children's views of their own interests. There is a tragic tension between informing and respecting sick children but also protecting them from avoidable stress. Yet protection can involve violence, as when treatment is enforced during efforts to protect children from disease. Rights entail responsibilities which can compromise yet enrich the child's autonomy