A/HRC/32/32 health-related services. It implies a fundamental shift in the traditional status of the child as a passive recipient of adult decisions and interventions. 56. In order to ensure the relevance and efficacy of interventions, adolescents’ experiences, concerns, knowledge and creativity should be utilized in the development, implementation and monitoring of relevant legislation, policies, services and programmes affecting their right to health and development at the school, community, local and national levels.32 Consultative mechanisms alone are insufficient to fulfil the right to be heard and to be taken seriously. Adolescents must be afforded safe spaces with opportunities to identify for themselves issues of most concern to them and to enable them to act on those concerns. Particular attention should be paid to adolescents with disabilities, who must be provided with disability and age-appropriate assistance to realize this right.33 Right to respect evolving capacities 57. During adolescence, the right to be heard and to be taken seriously transitions into the right to make autonomous decisions about one’s health care and treatment. The concept of children’s evolving capacities is an enabling principle addressing the process of maturation and learning through which children progressively acquire competencies and understanding.34 58. Not only is adolescence a period of considerably enhanced cognitive development, it is also associated with greater self- and social awareness, and the ability to grapple with complexity and to take into consideration the perspectives of others.35 These developments have profound implications for adolescents’ capacities to take increasing levels of responsibility for decision-making in respect of the right to health. 59. However, all too often States continue to deny adolescents the right to make autonomous and confidential decisions with regard to accessing health services by requiring parental notification or consent. These restrictions often make adolescents reluctant to access needed services so as to avoid seeking parental consent, which may result in rejection, stigmatization, hostility or even violence. 60. States are urged to consider the introduction of a legal presumption of competence that an adolescent seeking preventive or time-sensitive health goods and services, including for sexual and reproductive health, has the requisite capacity to access such goods and services. Where minimum ages of consent exist, as the Committee on the Rights of the Child has argued, any adolescent below that age and able to demonstrate sufficient understanding should be entitled to give or refuse consent. At a minimum, States should ensure a minimum age well below 18 years at which adolescents have the right to consent to or refuse services without mandatory authorization or notification of parent, guardian, spouse or intimate partner. The right to counselling and advice is distinct from the right to give medical consent and should not be subject to any age limit. 36 32 33 34 35 36 12 Ibid. Convention on the Rights of Persons with Disabilities, art. 7 (3). See Convention on the Rights of the Child, art.5, and Committee on the Rights of the Child general comment No. 7 (2006) on implementing child rights in early childhood. Sarah-Jayne Blakemore and S. Choudhury, “Development of the adolescent brain: implications for executive function and social cognition”, Journal of Child Psychology and Psychiatry, vol. 47, Nos. 3-4 (2006), pp. 296-312; and Sarah-Jayne Blakemore and Katheryn L. Mills, “Is adolescence a sensitive period for sociocultural processing?”, Annual Review of Psychology, vol. 65 (2014), pp. 187-207. Committee on the Rights of the Child general comment No. 12.