This thesis contends that the traditional legal and ethical approach to healthcare decision-making for children in mid-childhood is insufficient to meet the needs of those children, their families and the professionals that care for them. To address this failing I present a normative framework based on the Ethics of Care to aid in decision-making. My unique contribution to knowledge is first, to focus on children in mid-childhood (age 8 -14 years old); a neglected group in the jurisprudence, and contend that the current interpretation of Gillick competence and best interests fail to fully appreciate the child’s capabilities or accommodate the families views. Secondly, I assert that the Ethics of Care is well placed to address the needs of children in this age group, whilst fostering child participation. To this end I develop a novel Ethic of Care framework, based upon the work of Jo Bridgeman. Thirdly, I undertake a systematic review of the case law, spanning a 26-year period, and chart patterns and trends in judicial thinking. Finally, I test the utility of the framework by applying it to three areas on the legal fringes: end of life care, living organ donation and treatment for gender dysphoria.