Children have, since the 1980s, been able to give consent to treatment if they have “sufficient understanding”, a deliberately fluid concept that allows clinicians to respond to individual cases.

But there is concern where children refuse treatment that seems to be in their best interests, particularly if it is life-saving.

Such concerns have resulted in a distinction being drawn at law between “consent to” and “refusal of”, after a series of cases in which a child’s refusal was overridden. It is that legal distinction that allows Hannah’s choices to be challenged by her local healthcare trust.

The problem is how the law approaches the autonomy of minors. If it afforded the same respect to Hannah’s refusal to undergo a transplant as it would had she had consented, to surgery, there would be consistent and meaningful respect for the principle of informed self-determination.

Dr Bowman is a senior lecturer in medical ethics and law at St George’s Hospital, University of London

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