Children's Ethics and Medical Law

Question 1

Describe the children’s act

Answer 1

Children Act 1989: Persons with PR can consent to (and refuse) treatment on behalf of children.
BUT scope of parental consent is limited by best interests of the child

Question 2

Describe parental responsibility

Answer 2

Key points:
• All mothers have PR
• Biological father only has PR if married to mother at time of conception or birth (continues after divorce)
• Other people can obtain PR (stepparents, authority, adoption agency)
• Unilateral consent (only one parent is needed)

Question 3

Consent is not required if…

Answer 3

Consent is NOT required if there is evidence of:

1. Emergency (doctrine of necessity/emergency), but if you have time get a court order
2. Abandonment by the parents
3. Abuse/neglect by the parents

Question 4

Draw a flowchart to describe who can and can’t give consent

Answer 4

Question 5

Describe Fraser guidelines (specific to contraception)

Answer 5

GP must assess if:
Patient can understand advice (sufficiently mature)
Cannot be persuaded to inform parents or allow Dr to inform them
Patient is very likely to have sexual intercourse anyway (with/out adequate contraception/advice)
Patient’s mental/physical health are likely to suffer if contraception not given (e.g. unwanted pregnancy)
Advice/treatments is in patient’s best interests

Question 6

When can you breach confidentiality?

Answer 6

Can breach confidentiality if

• in best interests of public
• best interests of incompetent child
• legally required to do so

Question 7

What is Gillick competence?

Answer 7

Gillick competence:
• Each case is different
• A willingness to make a choice
• An understanding of the nature and purpose of the proposed intervention, its risks and side effects
• An understanding of alternatives to the proposed intervention, and these risks
• Freedom from undue pressure
But parents can override <16-year-old refusal to treatment

Question 8

What is the family reform act for minors?

Answer 8

The Family Law Reform Act 1969: 16 or 17 year olds can consent to treatment (consent for certain procedures is not covered by this)
But refusals by this group can be overridden by those with PR

Question 9

Give key elements of the children’s welfare act

Answer 9

Child, people with PR, court, people w/ temporary responsibility can give consent

Ppl with PR can consent to and refuse treatment for children (in best interests)
Courts can authorise or refuse treatment
PR is shared and unilateral consent usually sufficed legally

Question 10

Describe welfare in the children’s act

Answer 10

Welfare:

• Wishes and feelings of child
• Physical and emotional needs of child
• Likely effect of changes in family circumstances
• Harm suffered/likely to be suffered
• Age, gender and cultural background and other factors taken into account