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Children's participation in healthcare decision-making occurs within intricate ethical, legal, cultural, and social contexts. The United Nations' Convention on the Rights of the Child (CRC) and the Convention on the Rights of Persons with Disabilities (CRPD) advocate for children's autonomy and decision-making. On one hand, in many countries, including Canada and Japan, promoting a child's autonomy often hinges on the concept of the child's capacity. On the other hand, the CRPD introduced a social model approach to comprehending disability. This presentation reviews the current practising frameworks for children's healthcare decision-making in Canada and Japan, discussing the role of capacity in supporting the child's autonomy. Additionally, it compares the current status of the deinstitutionalisation of children in both countries and discusses the implication of the social model approach introduced in CRPD. Within the current medical and legal frameworks, capacity's role does not seem dismissible in promoting the child's participation in healthcare decision-making. While some argue that placing the child in an institution or residential care may be justified in limited circumstances to safeguard their best interests, others express concern that these exceptions could lead to prolonged institutionalisation of children with disabilities. Conclusion: Further deliberation concerning the interpretation and implementation of the CRPD and its relationship with the CRC is imperative. [ABSTRACT FROM AUTHOR]