1. From choice, a world of possibilities Young people as patients; Who decides?

2. Who are we talking about? Children : 0 - 18 years Youth : 15 - 25 years Adolescents : 10 – 19 years Young people : 10 – 24 years Source: UN & WHO

3. Some questions for you Would you let a 14 year old decide what clothes to wear? Would you let a 14 year old to go out clubbing till after 12 o’clock in the evening? Would you let a 15 year old go around the world sailing on her/his own?

4. Traditional notions of youth and adult Youth: Not adult/adolescent Becoming Pre-social self Powerless & vulnerable Less responsible Dependent Ignorant Risky behaviours Rebellious Reliant Adult; Adult/grown up Arrived Identity is fixed Powerful & strong Responsible Independent Knowledgeable Considered behaviour Conformist Autonomous

5. What makes (young) people vulnerable External side: Exposure Internal side: Coping Difference between risk and vulnerability Degrees of vulnerability Vulnerability is not static

6. What makes young people vulnerable as patients Lack of access to youth friendly services and programmes Cannot get youth friendly treatment, do not receive age appropriate information Attitudes of service providers Lack of access to justice Cannot get renounce to violations in care Gender Social norms create power imbalances and affect behaviour

7. Other challenges and dilemmas Lack of information on all aspects of health Self stigmatization of young people Parents, educators, and health providers may feel uncomfortable or unwilling to discuss certain health issues Mandatory parental consent requirements Lack of high quality age specific comprehensive services provided by supportive staff

8. From vulnerability to empowerment and resilience Look at young people from a different perspective: Youth is not just stage of development : social, legal perspective Young people are rights bearers wherever they are in the developmental spectrum Giving the balance right between autonomy and protection Support and understand their evolving capacity

9. Universal and particular elements in the conception of youth Universal Age status geographical location Global youth culture Compulsory schooling Legal prescriptions based on age, Adolescent development Youth as deficient Particular Social status, e.g., class, gender, ethnicity, race, Cultural formation Unequal provision, opportunities State regulation Diverse life experiences and cultural norms Youth having multiple dimensions

10. Protection versus autonomy The best interests of the child Evolving capacities of the young person Parental involvement

11. Convention of the rights of the child: Evolving capacity Article 5: young people’s evolving capacity to exercise their own rights must be taken into consideration by those who provide guidance and direction to young people Article 12: young people must be able to freely express their views, which should be given weight in accordance with their evolving capacity Article 14: young people must be afforded freedom of thought, conscience and religion

12. From vulnerability to empowerment Importance of role of adults but more ownership to young patients From determination by adults towards more self determination From obedience and dominance to listening to young patients and giving them a greater say in their decisions

13. Conclusions/recommendations Invest in youth-friendly health policies, programmes and services Engage with young patients as equal partners by providing opportunities for them to participate in decision-making, policy-making and advocacy

14. Some ideas we would like you to think about: When you want to involve young patients You need to learn more about them, their live, how their life is affected by the diseases and how their needs are constantly changing You need to have a positive view on young patients and avoid stigmatization and discrimination You need to be able to listen to young patients