State Consent to Termination of Pregnancy for an Incapacitated Minor under Article 42A and Section 9 of the 2018 Act: Commentary on DE (A Minor) [2025] IEHC 604

1. Introduction

1.1. The case in context

This High Court decision, In the Matter of DE (A Minor) [2025] IEHC 604, is a significant development at the intersection of:

• child law and the State’s powers under Article 42A of the Constitution,
• the minor wardship jurisdiction of the High Court, and
• the statutory regime governing termination of pregnancy under the Health (Regulation of Termination of Pregnancy) Act 2018 (“the 2018 Act”).

The case concerns a 15‑year‑old girl (almost 16) living in International Protection Accommodation who is 14 weeks pregnant and wishes to terminate the pregnancy. Medical evidence establishes a serious risk to her life if the pregnancy continues, principally due to threatened self‑harm. However:

• the minor lacks functional mental capacity to make the decision about termination herself; and
• both parents, for cultural and religious reasons, are unable to give consent to the procedure, though neither opposes the termination going ahead.

Against that background, the Health Service Executive (HSE) urgently applied to the High Court for:

• orders under the Court’s minor wardship jurisdiction to authorise the termination and related medical treatment; and
• the Court’s consent substituting for that of the parents, in light of Article 42A of the Constitution as interpreted by the Supreme Court in JJ [2021] IESC 1.

1.2. The key legal issues

The central issues before Barniville P were:

• Statutory compliance: Were the conditions of section 9 of the 2018 Act (“risk to life or of serious harm to health”) satisfied in respect of a minor?
• Capacity and consent: Did the minor have the functional mental capacity to consent? If not, could the parents’ refusal/inability to consent be supplanted by the Court?
• Scope of Article 42A: Was this an “exceptional case” within Article 42A.2.1 where parental “failure” in their duty – even confined to this single decision – justified State intervention?
• Use of wardship jurisdiction: Could the Court use minor wardship jurisdiction to give consent without formally taking the child into wardship, and how should proportionality operate?
• Gillick competence: Does Irish law recognise that a mature minor can make their own medical decisions (the so‑called “Gillick competence”)? The issue arose but, crucially, was left undecided.

The judgment answers most of these questions in a clear way, while explicitly postponing a definitive ruling on Gillick competence.

2. Summary of the Judgment

Barniville P (President of the High Court) delivered an ex tempore judgment on 29 October 2025 and:

• Held that the requirements of section 9 of the 2018 Act were clearly satisfied:
  • Two appropriate medical practitioners (an obstetrician/gynaecologist and a child and adolescent psychiatrist) had examined the minor and certified:
    • a risk of serious harm to her life if the pregnancy were not terminated,
    • non‑viability of the foetus, and
    • that termination was appropriate to avert the risk.
• Accepted uncontested psychiatric evidence that the minor lacked functional mental capacity to decide on termination, beyond the mere fact of her age.
• Found that both parents, for cultural and religious reasons, were not in a position to give consent, although neither opposed the termination proceeding.
• Relied centrally on the Supreme Court decision in JJ [2021] IESC 1 and Article 42A.2.1 of the Constitution to hold that:
  • the inability of the parents to provide consent in this specific instance amounted to a “failure” for Article 42A purposes,
  • this failure was likely to prejudicially affect the safety/welfare of the child given the grave risk to her life, and
  • the Court, as part of the State, could intervene by proportionate means to “supply the place of the parents” by consenting on the minor’s behalf.
• Exercised the Court’s minor wardship jurisdiction to provide consent to the termination and all ancillary medical treatment, without actually making the minor a ward of court.
• Adjourned the minor wardship summons for mention only, indicating that once the termination issue is dealt with, the proceedings may be struck out – emphasising proportionality and the targeted nature of the intervention.
• Noted that the question whether Irish law recognises Gillick competence (mature minor autonomy) does not have to be decided in this case because of the finding of incapacity.

Orders were made authorising:

• the termination by the named consultant obstetrician (or deputy),
• all medical and nursing care incidental or necessary to the termination, and
• any treatment for complications that might arise.

The matter was listed for review in mid‑November and costs were reserved.

3. Factual and Legal Framework

3.1. The factual background

Key factual points:

• The minor (“DE”) is a 15‑year‑old girl, nearly 16, residing in International Protection Accommodation.
• She was about 14 weeks pregnant at the date of the hearing; the pregnancy had been confirmed at over 12 weeks on 9 October 2025.
• DE expressed a clear and consistent desire to terminate the pregnancy and made alarming threats about what she would do if prevented from doing so, including:

  “cut the baby out with a knife” or procure unknown pills online in an effort to abort the pregnancy herself.

• She told psychiatrists she would “do whatever I have to and get rid of it” and “I will not have this baby”, acknowledging she might die as a result.
• There was no previous history of suicidal ideation or self‑harm; DE stated that if she were not pregnant, she would feel “happier than ever” and had aspirations for sport, modelling, and higher education, supported by high performance in the Junior Certificate.

Medical and professional input:

• Dr M, a consultant child and adolescent psychiatrist, conducted detailed assessments (with a colleague, Dr G) and:
  • concluded that DE’s insight and judgment were “somewhat poor”,
  • gave unequivocal evidence that, on a functional capacity basis, she lacked mental capacity to decide whether to proceed with a termination, even though her wish was clear and consistent, and
  • opined that there is a “risk of serious harm to the life” of DE within the meaning of section 9 of the 2018 Act, primarily due to the risk of self‑harm/suicide if compelled to continue the pregnancy.
• Dr C, a consultant obstetrician and gynaecologist, agreed that:
  • there is a risk of serious harm to DE’s life,
  • a medical termination should be carried out to avert that risk, and
  • the foetus was not viable (to be expressly confirmed for certification purposes).
• The proposed plan was:
  • medical management of the termination as an inpatient,
  • possible emergency theatre intervention in case of haemorrhage or retained conception, and
  • close specialist follow‑up with obstetrics and Child and Adolescent Mental Health Services (CAMHS).
• The Guardian ad Litem (GAL), Ms K, supported the application, considering it:
  • in line with DE’s clear and unambiguous wishes, and
  • in DE’s best welfare interests at this time.
• The Child and Family Agency (CFA), through a social worker and legal representation, also supported the application as being in DE’s best interests, stressing the need for comprehensive follow‑up supports.

Parental positions:

• Father:
  • Has recently arrived in Ireland (since 2023) and comes from a culture where abortion is not allowed.
  • Took a neutral stance – neither consenting nor objecting to the termination.
  • Could not formally consent due to his beliefs and a family tragedy associated with a termination in his country of origin, but wished to support his daughter through the process.
• Mother:
  • Believed that DE was competent and should make the decision herself, emphasising that:

    “it is a deeply personal thing for a woman to decide…”

  • Did not oppose the termination as such, but stated she could not herself provide consent to “a medical procedure that will end the life of another” because of her cultural and religious beliefs.
  • Considered her role to be to support her daughter after DE had made her own decision, and did not wish to “make the choice” for her.
  • Her legal team accepted that if evidence established DE’s lack of functional capacity, the mother would not oppose the termination but remained unable to consent.

3.2. The statutory framework: the 2018 Act

The 2018 Act regulates termination of pregnancy following the repeal of the Eighth Amendment. Two provisions are central:

• Section 2 – Definition of “woman”
  The Act defines “woman” to mean:

  “a female person of any age”

  This is crucial: it makes clear that the statutory regime applies to minors as well as adult women.
• Section 9 – Risk to life or health
  Section 9(1) provides that a termination may be carried out where two medical practitioners, having examined the pregnant woman, are reasonably and in good faith of the opinion that:
  • (a) there is a risk to the life, or of serious harm to the health, of the pregnant woman,
  • (b) the foetus has not reached viability, and
  • (c) it is appropriate to carry out the termination to avert the risk.
  Section 9(2) requires that:
  • one of the two practitioners be an obstetrician; and
  • the other be an “appropriate medical practitioner” (defined as appropriate to the care or treatment of the woman in respect of the risk at issue – here, a psychiatrist).
  Section 9(3) requires each practitioner to certify their opinion as to these matters, and section 9(4) requires the termination to be carried out by the obstetrician.

In DE’s case, Barniville P concluded that all elements of section 9 were met and would be formally certified.

3.3. The constitutional and jurisdictional framework: Article 42A and wardship

Article 42A, inserted following the children’s rights referendum, provides that:

“The State recognises and affirms the natural and imprescriptible rights of all children and shall, as far as practicable, by its laws protect and vindicate those rights.”

Critically, Article 42A.2.1 states:

“In exceptional cases, where the parents, regardless of their marital status, fail in their duty towards their children to such extent that the safety or welfare of any of their children is likely to be prejudicially affected, the State as guardian of the common good shall, by proportionate means as provided by law, endeavour to supply the place of the parents, but always with due regard for the natural and imprescriptible rights of the child.”

The State may thus, in “exceptional cases”, intervene to protect a child where parental “failure” would likely prejudice the child’s safety or welfare. The Supreme Court in JJ [2021] IESC 1 (discussed below) interpreted this provision and articulated how it interacts with the Court’s inherent child protection jurisdiction, including wardship. The High Court’s minor wardship jurisdiction is an inherent jurisdiction allowing the Court to make orders for the welfare of minors. After Article 42A and JJ, this jurisdiction must be exercised in a way that:

• requires a threshold of parental “failure” likely to prejudice safety/welfare, and
• is tailored and proportionate to the specific circumstances, rather than resorting automatically to full wardship.

In DE’s case, wardship proceedings were commenced, but Barniville P deliberately refrained from actually making DE a ward, using the jurisdiction instead as a legal vehicle for targeted, proportionate orders.

4. Precedents Cited and Their Influence

4.1. JJ [2021] IESC 1 – the constitutional foundation for intervention

The Supreme Court decision in JJ [2021] IESC 1 is described by Barniville P as “critical” to the jurisdictional analysis. While the facts of JJ were different (they involved a different form of medical treatment and parental objection), its principles are directly transplanted into the present context. From the judgment here, several key aspects of JJ emerge:

• Single‑instance “failure” is sufficient
  Barniville P emphasises that Article 42A.2.1 does not require the Court to carry out a global review of the parents’ overall performance in raising their child:

  “what is necessary to be established here or what is sufficient (at least) to be established is a single instance in which there could be said to be a failure by the parents.”

  The “failure” can be confined to a specific decision (or non‑decision) which, if unremedied, would prejudicially affect the child’s safety or welfare.
• Best interests and proportionality
  The Court must first determine whether the intervention sought is in the child’s best interests, and then whether it is a proportionate intervention under Article 42A.2.1 – that is, no more intrusive than necessary to address the risk.
• Narrow, issue‑specific orders under wardship
  JJ makes clear that the Court may make orders in wardship‑type proceedings without formally taking the child into wardship, and that it should avoid unnecessarily broad orders where narrower relief suffices.

In DE’s case, these principles are used to:

• characterise the parents’ inability to consent, in this specific instance, as a “failure” for Article 42A purposes;
• justify State (court) intervention to provide consent, in light of the very serious risk to the minor’s life;
• limit the response to targeted authorisation of the medical procedure, without making the child a ward or interfering more widely with parental responsibility.

4.2. XY [2013] IEHC 12 and “Gillick competence”

The judgment refers briefly to the concept of “Gillick competence” and its uncertain status in Irish law. Gillick competence (from UK case law) holds that a minor under 16 can consent to medical treatment if they have sufficient understanding and intelligence to understand fully what is proposed. Barniville P notes that:

• the concept had been touched on by Birmingham J (as he then was) in XY [2013] IEHC 12, but not definitively adopted or rejected;
• it is an “interesting” issue that “may require to be decided in another case”, but need not be decided here because of Dr M’s “unequivocal” evidence that DE lacks capacity.

Thus, DE’s case does not settle whether a competent minor could personally consent to a termination under Irish law. Instead, it:

• acknowledges the concept’s relevance;
• confirms that Irish law still does not formally resolve the status of Gillick competence; and
• rests the present decision on a finding of incapacity, so that the issue is left for a future, more suitable case.

5. The Court’s Legal Reasoning

5.1. Compliance with section 9 of the 2018 Act

The Court methodically applied section 9 to the evidence.

1. Risk of serious harm to life or health – s.9(1)(a)
   Dr M’s short report of 20 October 2025 stated that there is a “risk of serious harm to the life” of DE if she must continue the pregnancy. Dr C concurred. The risk flows primarily from DE’s clear and repeated threats of serious self‑harm and apparent indifference to her own survival if denied a termination.
   
   Barniville P was satisfied, on uncontested evidence, that section 9(1)(a) was met.
2. Non‑viability of the foetus – s.9(1)(b)
   Dr M expressly stated that the foetus is not viable. Dr C’s further opinion confirming this was to be documented (an undertaking was given that she would do so and that it would be reflected in the certification). The Court accepted that the non‑viability requirement was, and would be, satisfied.
3. Appropriateness of termination – s.9(1)(c)
   Both doctors expressed the opinion that a termination is appropriate to avert the risk. The proposed management plan (medical termination, inpatient care, emergency back‑up, follow‑up mental health care) was described in some detail and accepted by the Court as clinically appropriate.
4. Correct practitioners – s.9(2)
   The two practitioners were:
   • Dr C – an obstetrician, satisfying s.9(2)(a); and
   • Dr M – a child and adolescent psychiatrist, clearly an “appropriate medical practitioner” for the psychiatric risk, satisfying s.9(2)(b).
5. Certification – s.9(3)
   The Court was satisfied that the requisite certification would be and was being completed as required, reflecting the opinions set out in their reports and letters.
6. Performance by obstetrician – s.9(4)
   The termination would be carried out by Dr C, the obstetrician, in accordance with s.9(4).

Barniville P concluded that “the requirements of section 9 are, in my view, therefore, complied with in this case.” Importantly, this analysis explicitly acknowledges that the 2018 Act applies to “a female person of any age” and thus covers minors, with questions of consent handled by general legal principles and wardship.

5.2. Capacity and the minor’s inability to consent

The Court accepted Dr M’s unequivocal evidence that DE lacked the functional mental capacity to make a decision about terminating her pregnancy. This was not a simple matter of youth; it was a substantive finding of impaired decision‑making ability:

• Her wish for termination was fixed and consistently expressed.
• However, her insight and judgment were “somewhat poor”.
• On a functional capacity analysis – i.e. looking at whether she could understand, retain, weigh, and communicate the information needed to decide – she did not have capacity.

Barniville P underscores that:

“there is no contrary evidence, so I must accept as a matter of fact that the minor, not just by virtue of her age but by virtue also of her mental capacity (assessed on a functional capacity basis), does not have the capacity to make a decision in respect of the termination of her pregnancy…”

Because DE could not lawfully consent, some other lawful source of consent was required to proceed with a medical intervention of this nature.

5.3. Parental non‑consent and Article 42A “failure”

The parents’ positions presented a nuanced challenge:

• They did not oppose or seek to prevent the termination.
• However, both, for deeply held cultural and religious reasons, could not themselves give formal consent to the procedure.

This created a lacuna: a high‑risk procedure for an incapacitated minor, with no legally effective consent provider at hand. Drawing on JJ, Barniville P applies Article 42A.2.1:

“what is necessary to be established here or what is sufficient (at least) to be established is a single instance in which there could be said to be a failure by the parents.”

He stresses:

• The Court is not conducting an overall assessment of the parents’ performance or general suitability.
• The “failure” is confined to this specific decision: the parents’ inability to provide the consent which the child, lacking capacity, requires.
• On the evidence, that failure is:
  • likely to lead to “prejudicial effects” for the minor, since if the procedure does not proceed there is a “very grave risk to her life”; and
  • thus meets the threshold of Article 42A.2.1.

Once such a failure is established, Article 42A authorises the State, as guardian of the common good, to intervene “by proportionate means as provided by law” to “supply the place of the parents.” In this case, the proportionate means consist of:

• The HSE’s application for specific orders authorising the termination and associated treatment; and
• The Court’s use of its minor wardship jurisdiction to provide consent on DE’s behalf.

5.4. Best interests and proportionality

Before exercising the jurisdiction, the Court had to be satisfied that:

1. The procedure was in the child’s best interests; and
2. The intervention was proportionate under Article 42A.

On best interests, Barniville P relied on:

• The serious, medically documented risk to DE’s life if the pregnancy continued;
• The strong, informed and consistent wish of DE herself to have a termination;
• The clear support of:
  • the Guardian ad Litem,
  • the Child and Family Agency, and
  • the treating clinicians;
• The proposed follow‑up care and multidisciplinary support.

He concluded:

“I am quite satisfied on the evidence… that this is in the minor's best interests.”

On proportionality, drawing again on JJ, the Court took care to:

• Limit the scope of the orders to what was strictly necessary – authorising:
  • the termination by the obstetrician,
  • related assessment and treatment, and
  • treatment of any complications.
• Refrain from taking DE into wardship, stating explicitly:

  “I am not going to make any order taking the minor into wardship today as I do not believe that it is necessary to do so…”

• Adjourn the wardship summons for review, with an expectation that it may later be struck out once the immediate issue is resolved.

This calibrated approach underscores that Article 42A interventions must be tailored to the precise risk and time‑limited where possible, rather than permanently displacing parental responsibility.

5.5. The unresolved question of Gillick competence

The Court briefly acknowledges submissions regarding whether Irish law recognises “Gillick competence” (i.e. the ability of a mature minor to consent to medical treatment, even without parental consent). Barniville P notes:

• The issue has been previously mentioned by Birmingham J in XY [2013] IEHC 12;
• It may need to be decided in a future case;
• It is not necessary to decide it here, because:
  • Dr M’s psychiatric evidence is that DE lacks capacity; and
  • All parties ultimately accepted that if DE lacks capacity, parental consent or court consent is required.

Thus, while the case edges around the edges of adolescent autonomy and competence, it does not resolve the question. That remains a live, and increasingly important, issue for Irish child and medical law.

6. Complex Concepts Simplified

6.1. Minor wardship jurisdiction

The “minor wardship” jurisdiction allows the High Court, in exceptional circumstances, to step into the shoes of parents and make decisions for a child’s welfare. Traditionally, this could involve:

• taking a child into “wardship” (placing them under the Court’s protection); and/or
• authorising particular medical, educational, or placement decisions.

Since Article 42A and JJ, this jurisdiction must be exercised:

• only where there is parental “failure” likely to harm the child, and
• in a way that is proportionate and limited to what is necessary.

In DE’s case, wardship proceedings were the legal mechanism through which the HSE asked the Court to authorise the termination, but the Court made only specific orders and did not make DE a ward.

6.2. Article 42A and the child’s rights

Article 42A:

• Recognises “the natural and imprescriptible rights of all children” – rights that are inherent and cannot simply be taken away; and
• Allows the State, in “exceptional cases”, to intervene when parents fail to protect their children’s safety or welfare.

Key points:

• The “failure” can be a single decision rather than a general pattern of neglect or abuse.
• The State’s intervention must be:
  • “by proportionate means” – no more drastic than necessary; and
  • “as provided by law” – through proper legal processes and powers, such as wardship.
• The child’s own rights and welfare are central; parental rights, though important, are not absolute.

6.3. Functional decision‑making capacity

“Functional capacity” means assessing whether a person can make a specific decision at a particular time, rather than asking whether they are generally “of sound mind”. For a medical decision like termination of pregnancy, capacity typically involves being able to:

• understand relevant information – nature and consequences of the procedure, alternatives, risks;
• retain that information long enough to make a decision;
• weigh the information – appreciate pros and cons in a rational way; and
• communicate a clear choice.

DE’s clear wish to end the pregnancy is only one element. Dr M concluded that due to her poor insight and judgment, she could not properly weigh and understand the decision. The Court accepted that she lacked capacity in this functional sense.

6.4. Gillick competence

“Gillick competence” originates in English law (from Gillick v West Norfolk and Wisbech AHA [1986]) and holds that a child under 16 can consent to medical treatment if they have sufficient understanding and intelligence to fully comprehend the proposed treatment. In Ireland:

• The concept has been discussed judicially (e.g. in XY), but has not been clearly adopted or rejected;
• DE’s case affirms that:
  • the concept is known and relevant; but
  • its status remains open, because this case was decided on the basis of incapacity.

A future case involving a mature, capacitated minor seeking or refusing significant medical treatment (including perhaps termination of pregnancy) will likely revisit this question.

6.5. “Viability” in the abortion context

Under the 2018 Act, particularly in sections like 9, one condition for lawful termination is that the foetus “has not reached viability”. While the Act does not fix an exact gestational age, “viability” generally refers to the stage at which the foetus could survive independently outside the womb with appropriate medical support. In DE’s case:

• At 14 weeks, the foetus was clearly pre‑viable.
• Dr M confirmed non‑viability; Dr C agreed and undertook to certify this formally.

6.6. Guardian ad Litem

A Guardian ad Litem (GAL) is an independent person appointed by the court to:

• ascertain and convey the child’s wishes, and
• advise the court on what is in the child’s best interests.

Ms K, as GAL for DE, carried out this role by:

• meeting with DE and her parents;
• assessing the circumstances; and
• concluding that authorising the termination was both:
  • in DE’s best interests; and
  • aligned with DE’s clearly expressed wishes.

6.7. “In camera” hearings

The proceedings were conducted in camera, meaning:

• they were heard privately, not in open court; and
• attendance and reporting restrictions applied.

This was ordered under section 45 of the Courts (Supplemental Provisions) Act 1961, reflecting the sensitivity of minor wardship and medical matters, and the need to protect DE’s privacy.

7. Impact and Future Significance

7.1. Clarifying how the 2018 Act operates for minors

The judgment reinforces and clarifies that:

• The termination regime in the 2018 Act explicitly extends to minors by defining “woman” as “a female person of any age”.
• Where a minor is incapacitated, and parental consent is not forthcoming (even if due to conscientious objection rather than active opposition), the Court can provide consent in the child’s best interests under Article 42A and wardship.
• Threats of self‑harm or suicide if forced to continue a pregnancy can constitute a “risk to life or of serious harm to health” under section 9, provided appropriate psychiatric and obstetric evidence supports this.

This has practical significance for clinicians and lawyers dealing with:

• adolescent pregnancies in complex psychosocial contexts;
• cases where parents’ religious or cultural convictions prevent them from consenting to a lawful termination; and
• the interface between mental health risk and termination under the Act.

7.2. Article 42A and “single‑issue” parental failure

By treating the parents’ inability to consent in this single instance as sufficient “failure” under Article 42A.2.1, the judgment gives concrete shape to an important aspect of JJ:

• Parents need not be generally neglectful or abusive; a specific, acute decision can trigger State intervention if it endangers the child’s safety or welfare.
• Conscientious or cultural reasons for a parental position do not immunise that position from scrutiny if it puts the child at serious risk.
• However, the Court is careful not to condemn the parents; Barniville P explicitly refrains from making any broader findings against them, recognising their understandable personal position.

This will likely influence future cases concerning:

• parental refusal of life‑saving or life‑preserving treatment for children (for example, on religious grounds);
• disputes about high‑risk elective treatments; and
• other contexts where a child’s welfare is seriously jeopardised by a particular parental decision or indecision.

7.3. Proportionality and non‑wardship solutions

The judgment illustrates, in a very practical way, how proportionality under Article 42A can be honoured:

• Proceedings were commenced in wardship to give the Court jurisdiction, but
• The Court confined itself to the minimum necessary orders:
  • authorising the termination and associated care only,
  • not making DE a ward, and
  • signalling that the proceedings may be struck out once the issue is resolved.

This sets a template for future cases: the Court can and should:

• address the specific medical or welfare issue in question;
• avoid unnecessarily broad or indefinite orders; and
• step back once the acute issue is resolved.

7.4. The unresolved trajectory of adolescent autonomy

Although the judgment does not decide the Gillick competence question, its discussion of functional capacity and its explicit reference to XY mean that:

• The issue of mature minors’ ability to consent to complex medical procedures, including termination, remains very much alive.
• Future cases will likely test whether a 15‑ or 16‑year‑old with robust, demonstrated understanding can make such decisions without parental or court consent.
• The decision in DE may indirectly encourage clearer statutory or judicial guidance on capacity and consent for minors, especially in areas as sensitive as reproductive healthcare.

7.5. Cross‑cultural dimensions and international protection contexts

DE’s circumstances – a young person in International Protection Accommodation, with parents newly arrived from a culture where abortion is prohibited – foreground the increasing importance of:

• respecting parental religious and cultural beliefs; but
• ensuring that those beliefs do not place children at serious risk.

The judgment strikes a careful balance:

• It respects the parents’ refusal to consent as sincere and understandable;
• It does not criticise their broader parenting; but
• It is firm that where the child’s life is at “very grave risk”, the State must be able to act, even if this means overriding or bypassing parental religious or cultural objections.

This has broader resonance for child protection and health law in a multicultural Ireland.

8. Conclusion

8.1. Key takeaways

This ex tempore judgment, although fact‑specific, lays down clear and important principles:

• Application of the 2018 Act to minors: The definition of “woman” as “a female person of any age” means the 2018 Act, including section 9, fully applies to minors. Where statutory conditions are met, a termination may lawfully be carried out on a pregnant minor.
• Capacity and consent: A minor’s age does not automatically determine capacity. A functional mental capacity assessment is required. Here, DE lacked capacity to decide about termination, so someone else had to lawfully consent.
• When parents cannot consent: Where parents, for conscientious or other reasons, cannot provide consent for an incapacitated child’s necessary medical treatment, that may constitute a “failure” under Article 42A.2.1, even if their motives are understandable and confined to a single decision.
• Role of the State and the Court: In such exceptional cases, the State – through the High Court’s minor wardship jurisdiction – may intervene to “supply the place of the parents”, giving consent in the child’s best interests, subject to proportionality and legal safeguards.
• Proportional interventions: The Court should tailor its orders narrowly to the immediate risk, using wardship to authorise specific treatment without necessarily making the child a ward or displacing parents more broadly.
• Unresolved Gillick competence: The judgment confirms that the status of Gillick competence in Irish law remains open; it was not necessary to decide the issue here because the minor lacked capacity.

8.2. Significance in the broader legal landscape

DE (A Minor) [2025] IEHC 604 will likely be cited as a leading authority on:

• how the courts should handle termination of pregnancy for minors in complex capacity and consent scenarios;
• the practical application of Article 42A and JJ in “single‑issue” parental failure cases, especially in the medical domain; and
• the proper, proportionate use of wardship jurisdiction in the post‑Article 42A era.

It also illustrates a humane, child‑centred approach to a profoundly difficult situation, balancing:

• DE’s own wishes and welfare,
• her parents’ sincerely held beliefs,
• the professional duties of clinicians, and
• the constitutional obligations of the State to protect children’s fundamental rights.

While many questions about adolescent autonomy, capacity, and reproductive decision‑making remain for the future, this judgment marks an important step in clarifying how Irish law responds when a pregnant minor is both unable to decide for herself and unprotected by parental consent – especially where her life is at grave risk if treatment is withheld.