In this situation, a 14-year-old child is competent and has the legal right to decide what happens to him. However, it depends on a number of factors including socio-cultural background. In the United States, laws governing minors’ rights vary from state to state but generally speaking, minors are not considered legally competent enough to make decisions about their own medical care until they reach the age of 18. This means that even if a minor meets certain criteria for competence—such as being able to understand and articulate his wishes with respect to medical treatment—they may not be able to exercise their autonomy without permission from parents or legal guardians.
In an ethical sense, one could argue that people should have the right of self-determination regardless their age. This argument, however, must be considered in light of other issues, including potential dangers associated with some treatments. To decide upon an appropriate outcome in cases where disease states intervene—as is seen in this scenario—it is important for healthcare providers and family members alike seek out informed consent while also taking into account any cultural customs that may influence decision making. In the end, every situation needs to be evaluated individually and each party should work towards finding a solution that balances individual autonomy while also balancing safety concerns.