In R (Axon) v Secretary of State for Health the Gillick competence test was confirmed. Commitment to childhood autonomy and privacy rights caused renewed academic criticism of the 'refusal' cases. This paper considers the form any changes to the law may take, and the potential consequences for the rights of parents and young people. Silber J.'s contention that parental Article 8 rights cease when the child makes a competent decision is potentially problematic if applied to refusal cases, especially in the context of the distinction between competence to consent to treatment and to the disclosure of information.