Consent In Children Flashcards
Which two issues did Gillick competence arise from?
Confidentiality
Consent
What’s the relationship between confidentiality and consent, in the case of children?
Drs have duty of confidentiality to all patients, regardless of age
Parents are legally responsible for their children (inc health matters)
Parents are therefore unable to exercise responsibility over their child properly, if Drs are unable to share info with them
Unable to make decisions if they don’t know there is a decision to be made and if they’re not given relevant info upon which to base the decision
= Drs must share relevant info with parents to allow them to exercise their parental responsibility
What are the 3 elements of consent?
Information
Voluntariness (freedom from coercion)
Capacity
= decision that patient is able to communicate
What’s the legal definition of a child? Which convention?
United Nations Convention on the Rights of the Child
18 (16 in Scotland)
Parental responsibility holds until 18
What does UNCRC cover? Which is the most important article for healthcare?
Right to life, survival and development
Protection rights
Article 12: participatory rights = when adults are making decisions that affect children, children have the right to say what they think should happen and have their opinions taken into account
How should children’s views be treated in medicine?
Those under 18 should participate in decisions concerning themselves
But they don’t have the power to decide matters for themselves
They can obtain power to consent if they have capacity
From what age does the MCA 2005 apply?
16 and over
Outline Gillick competence
There’s no fixed age for capacity -
It depends on: the degree of maturity, understanding and nature of decision to be made
It’s decision-specific
What’s the difference between children and adults consenting to treatment, with regards to capacity?
Children need to ‘fully understand’ = greater level of capacity required, they need to demonstrate that they have the capacity
Whereas adults merely need to understand
What’s the main concern when considering whether children can consent?
Dr must act in best interests
What’s the GMC guidance on consent in children?
Capacity to consent depends on young peoples ability to understand and weigh up options, more than being based on age
Capacity to consent can be affected by their physical and emotional development and changes in their health and treatment
What are the 3 criteria for consent and how are they affected in children?
Information - may not understand information
Voluntariness - children more vulnerable to coercion
Capacity - may not be mature enough to fully understand implications
What are the Fraser guidelines specific to?
Issues of contraception, absorption and STI
What are the 5 criteria that need to be fulfilled in the Fraser guidelines?
That the girl under age of 16 will understand Dr advice
That Dr cannot persuade child to inform their parents
They child is very likely to continue having sexual intercourse with/without contraceptive treatment
That unless child receives contraceptive advice or treatment, their physical/mental health are likely to suffer
That child’s best interests require Dr to give contraceptive advice/treatment
Under the Sexual Offences Act 2003 when is someone not guilty?
If Dr acts in purpose of:
Protecting child form STI
Protecting physical safety of child
Preventing child from becoming pregnant
Promoting child’s emotional wellbeing by giving of advice
