 Fourth, the English courts at least have detected a fundamental asymmetry between refusing and choosing to have treatment. A competent adult has a right both to choose to have treatment and to refuse it. Should this not also be the case with a competent child? A 15-year-old who wants to have a particular operation against her parents’ wishes and even contrary to the best judgement of her doctors may be judged competent and thus have her wishes respected. However the English courts in a series of judgements after Gillick have argued that matters are somehow different when it is a case of a child refusing an operation. 