I don't think most 11 year olds today even really understand what money is yet, other than if they're good they get a few extra things. They won't know or care what 'cancer' is unless they're feeling the physical effects and obviously feel burdened enough by it.

Also, most states require older kids being put up for adoption to consent (talk about an awkward question- not anymore than Isaac and Abraham but still), usually at adolescence but it can be as young as the age you're referencing.

Obviously it depends on the society. Back in the day kids got married in their teens and earlier often because the times required maturity or more directly people of all ages were exposed to the horrors of life at earlier ages. If you didn't work, and hard, you died. It was a time of constant war, and whether due to that or simple disease folks didn't end up living too long anyhow. It takes a bit of imagination to really understand but most people were "adults" as we define by age 12 or so. These days, you can live and die at an old age, going through the entirety of life with the mindset of a "child" as we define it. The blessing (or curse) of modern society and the stability that comes with it. Some don't forget. And so, are advantaged over those who do.

There is a surgery that has a 20% chance of failure and even if the surgery is successful there may be lasting effects that will affect the child in the future. How much input does that child on whether to go on with the operation? — Brandon G

100% dead v. 20% dead. And the first option an unpleasant death. I invite you to recast the question. That is, what is a child in this context? Adults get to make not-so-good choices because they're adults. Children are not adults. The remaining question is does a child get to make a not-so-good decision? Ans.: pretty much, no. In present example? None.

What if the surgery is not a matter of life and death? Something less severe but that still has important implications wrt personal identity?

One example I can think of is MTF/FTM transitions. I am not sure what the politically correct term is here, so please forgive me. Neither am I a medical professional, so I'm not too sure on the intricacies behind it.

M/F go through different physical changes during puberty, and I imagine some of those effects will be irreversible past a certain age. Should the child be able to decide if they want to have such a surgery / medical procedure?

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Yes, that is exactly what I thought about when reading the post but thought maybe the transgender part was a different debate but I see that you are making this link as well.

But in England we have just had the whole case of Kiera Bell, a woman who took puberty blockers before transitioning to become male because at age 23 she is wishing to detransition back to female. She developed a case saying that the puberty blockers and treatment to become male should have not happened at that time. She argued that, being an adolescent, she lacked 'capacity to consent', having not been given full psychological exploration when she made decisions at the age she was and she felt unable to weigh information critically prior to adulthood.

This week, it appears that her case has been taken forward as part of an argument against adolescents having capacity to consent, with the effect of puberty blocker medication being outlawed.This has sparked off a lot of anger amongst transgender teenagers, because the whole option of puberty blockers would make transitioning to the desired gender much easier.

So, the whole issue of children and surgery has vast consequences for surgery of all kinds, specifically those relating to transgender and intersex people.

In the case, of intersex individuals many were often arbitrarily assigned to genders, and some were even given surgery, or hormones without being given choice. Some may have to resort to treatment to realign with their wishes in adulthood, and have treatment in the preferred direction at a later stage. However, it could be argued that the individuals should have been asked what they wished for when they were growing up, rather than the issue being addressed much later.

So, I would say that this whole post raises big questions indeed, especially in the whole area of gender.

But outside of gender, I believe that the question of children and medical treatment raises questions about choice and would suggest that the whole issue of capacity to consent is fundamental to the debate, but this does not mean dismissing the views of the children or adolescents who are the subjects concerned..

It's a question of who knows better/best and who is responsible. Children don't and aren't. Children of an age do get to express a preference in some custody cases, but it's not their determination. And parents who withhold appropriate medical care are subject to criminal penalties.

As to gender choice, letting a child make that choice in terms of irreversible medical procedures is insanity, and likely no MD would perform such procedures without overwhelming justification and cause.

Small point: to my knowledge there exists no clear definition of any version of sexuality. None. So how does a kid make a good life decision without even external clarity on the issue?

https://www.itv.com/news/2020-12-01/high-court-rules-children-under-16-can-only-consent-to-puberty-blockers-if-they-understand-treatment

By a reasonable age, I mean children in secondary education. — Brandon G

It's a cultural thing. There is no right answer - no fact of the matter that applies to all people at a certain birthday. Having said that, it seems to me that the competence to refuse treatment would come before the competence to demand it. It relates to other expectations laid upon the young person. For instance I suppose that the age at which one is considered competent to bear arms and die for one's country should not be earlier than the age at which one is competent to vote for one's government, get rat-arse drunk, and have the last say about any possible medical treatment.

On the other hand, it cannot be denied that psychologically, some people never grow up. But one cannot legislate for that, except at the extreme.

Children should not be allowed to decide as they do not have financial knowledge nor the moral as well as medical knowledge .To some extent ,Teenagers can have a choice as many already know about the things that may happen and if money is not a problem a teenager can be held responsible for the things the thing that might happen to them.