Ethics

Question 1

describe GMC guidelines on gaining consent in children

Answer 1

at 16 years or older a young person can be treated as an adult and can be presumed to have capacity to decide

under the age of 16 years children may have capacity to decide, depending on their ability to understand what is involved

where a competent child refuses treatment, a person with parental responsibility or the court may authorise investigation or treatment which is in the child’s best interests (except Scotland)

Question 2

explain the Fraser guidelines for provision of contraception to patients under 16

Answer 2

• the young person understands the professional’s advice
• the young person cannot be persuaded to inform their parents
• the young person is likely to begin, or to continue having, sexual intercourse with or without contraceptive treatment
• unless the young person receives contraceptive treatment, their physical or mental health, or both, are likely to suffer
• the young person’s best interests require them to receive contraceptive advice or treatment with or without parental consent

Question 3

describe advance directives

Answer 3

must refer to specific treatment in a specific circumstance

individual must have been of sound mind

mental capacity act 2005 states that this is binding with the following exceptions
- decision has subsequently been withdrawn
- Lasting power of attorney overrules this
- since making this the patient has acted in a way that is clearly inconsistent with decision
- person is not incapacitated and can decide for themselves
- treatment in question is not specified in advanced directive
- reasonable grounds to believe that circumstances exist which the person did not anticipate at the time of advance decision