While much criticism has surrounded the seemingly incoherent law governing decision-making for adolescents, relatively little work has sought to address the question of whether and when adolescents will be acting autonomously in decisions to refuse treatment, particularly in cases where their choices are motivated by religious beliefs inculcated from a young age. This is important, not just because it goes to the heart of when an adolescent ought to be able to exercise a right to self-determination, but also because an analysis of the case law indicates that judges are taking account of concerns about the authenticity of the values or beliefs which motivate a given decision when deciding cases. This paper will examine how different accounts of autonomy and authentic choice map onto the psychological development of adolescents, and thus the extent to which adolescent's decisions to refuse treatment on religious grounds can be regarded as truly authentic. It will conclude by considering how such cases ought to be approached by the courts, suggesting a modified Mental Capacity Act 2005 test for assessing adolescent capacity, and offering an empirically-grounded justification for overriding the choices of even capacitous adolescents.

中文翻译：

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青少年决策的真实性和同一性

尽管围绕着看似不连贯的青少年决策法律受到了很多批评，但相对较少的工作试图解决青少年是否以及何时会自主做出拒绝治疗的决定的问题，特别是在他们的选择是出于宗教动机的情况下。从小就灌输的信念。这很重要，不仅因为它涉及青少年何时应该能够行使自决权的核心，而且因为对判例法的分析表明，法官正在考虑对青少年的真实性的担忧。在决定案件时激发特定决定的价值观或信念。本文将研究对自主性和真实选择的不同解释如何映射到青少年的心理发展，从而探讨青少年基于宗教理由拒绝治疗的决定在多大程度上可以被视为真正真实的。最后，它将考虑法院应如何处理此类案件，建议修改《2005 年心理能力法》测试来评估青少年的能力，并提供基于经验的理由，以推翻甚至是有能力的青少年的选择。