Gilick competence and Fraser guidelines Flashcards
What are the criteria for the Fraser guidelines? Note: Fraser guidelines are specific to contraception
- The girl (although under the age of 16 years of age) will understand his advice; 2. that he c_annot persuade her to inform her parents_ or to allow him to inform the parents that she is seeking contraceptive advice; 3. that she is v_ery likely to continue having sexual intercourse with or without contraceptive treatment_; 4. that unless she receives contraceptive advice or treatment her physical or mental health or both are likely to suffer; 5. that her best interests require him to give her contraceptive advice, treatment or both without the parental consent.”
Note: A child under the age of 13 is always considered to be unable to consent for sexual intercourse. –> refer to social services
How do you know if a child is Gilick competent?
Gilick competence is used to determine whether a child under the age of 16 is able to give consent for medical treatment without the need for parental permission and knowledge
Child must be able to:
- Understand what is being asked of them
- Reason the pros and cons
- Retain the information?
- Able to respond / relay their answer\
A 15-year-old boy from Birmingham is brought to surgery by his mother complaining of abdominal pains for the past two days. On examination there is a clinical suspicion of appendicitis and a referral to hospital is planned. On discussing this with the patient he refuses to be admitted as he had planned to go to a party tonight. He is able to understand all information you give him and repeat it, including the serious nature of untreated appendicitis. What is the most appropriate course of action?
A. An independent legal guardian should be appointed
B. As he has demonstrated capacity, his wishes should be respected
C. An approved social worker should be appointed
D. A psychiatric opinion is mandated first
E. His mother may overule his wishes
E.
In England and Wales a child has the ability to consent to, but not refuse, treatment. Whether a child has demonstrated capacity (as per the Fraser guidelines) is not the relevant issue.
