Consent In Children Flashcards
What is the UN legal definition of a child?
Every human being under 18 unless majority is attained earlier
Uk age of majority = 18 - parental responsibility holds until 18
Scotland = 16
What does the MCA say about capacity in those over 16
A person aged 16 and above is assumed to have capacity to make decisions and give consent for medical treatment
What does the UN convention on rights of children say about adults making decisions on behalf of children?
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
What do the UN, Children’s Act and GMC say about best interests of children?
UN: children’s best interests must be primary concern
Children’s Act: welfare of child must be primary concern
GMC: use child’s best interests to make decision - consider views of parents, spiritual/cultural beliefs + views of HCPs involved
What does GMC guidance say about consent in children?
- capacity to consent depends more on the persons ability to understand and weigh up options than on age
- capacity to consent might be affected by their physical and emotional development or by changes in their health or treatment
- children might be able to consent for risk free treatment but not high risk
Who can consent for treatment for a child?
Somebody with parental responsibility
Courts can authorise treatment decisions
Young person 16-17 assumed to have capacity
Young person <16 with gillick competence
May treat without consent in emergency
Which statute governs rights of children?
The children’s act 1989
What does the GMC say about children without the capacity to consent?
If a child lacks capacity to consent, a parent can consent. 1 parents consent is sufficient. If parents disagree and disputes cannot be resolved then must seek legal advice
Name some issues with parents/people with parental responsibility giving consent for children without capacity?
- they must have capacity
- some parents are minors themselves
- may have mental impairments that restrict their ability to make decisions
- parents themselves may be affected e.g. same RTA as their child
How do courts deal with consent in children without capacity?
Look as objectively as possible at best interests of child
Child’s interests are paramount
Will be guided by doctors but may have to decide between medical opinions if doctors disagree
What should we consider when treating a child without consent?
Views of the child/young person Views of the parent Views of others close to the child Cultural/spiritual/religious beliefs Views of other HCPs involved in care Making a choice which will least restrict the child’s future
Name some difficulties involved with treating children who cannot consent?
No objective test for best interests - subjective so lots of room for disagreements
Parents may disagree with each other or with doctors
Doctors may disagree with each other
Parents may have obligations to other minors
What is a doctors professional responsibility when treating children who cannot consent?
act in child’s best interests
Treat patient with respect, involve them in discussions and decisions if possible
Challenge parental authority through courts if necessary
Should:
Explain things in a way the child can understand, give them opportunities to ask questions, be open and honest with the child and parents whilst respecting confidentiality
The GMC do not permit doctors to undertake which procedures if the child cannot consent?
If there is no benefit to the patient in the immediate term or if there is no obvious therapeutic benefit e.g. circumcision or correction of physical property
