medical treatment of children Flashcards
default position for adults (over 16)
-a competant adult had the right ot consent to medical treatment
-competence is assumed unless shown otherwise
-if not competent- to be treated according to their best interests
-competence from mental capacity act 2005- capacity to make decisions, understand, retain, weigh, communicate (doesnt have to be verbal)
over 16s
-same as an adult
-consent at this age overrides non-consent of a parent
-Re W 1993- parents can consent but only if its in the best interests
-Re C 1997- father consented to 17 year olds eating disorder treatment, in best interest for her to get so ordered
-Re P 2003- court reluctant to order blood tranfusion for nearly 18 year old, but did as in best interet
under 16s
-default- lack capacity
-parental responsibility includes power to consent on behalf of child
-can prove they have capacity though from:
Gillick v W norfolk and wisbech AHA 1985-
-mother wanted court order saying doctors were forbidden to advise her child on birth cotrol without her permission, health authority would not give garuntee so she took them to court, HOL health authority won
-children under 16 can get medical treatment if they are sufficiently mature (gillick competence)
-R Axon v SOS for health 2006- review of advice given to children on sexual matters, argue that against parents right to family and private right, doesnt win against the rights of a competent child
when does Gillick
no statutory rule as comes from case law
-Re S 2017- need to look at elements of capacity used in MHA2005
(understands consequences of actions/inactions, retain info,weight pros/cons, communicate
-if consequences are more sever the courts place greater emphasis on where the child weighed the pros and cons
- understanding
-Re JA- need to understand the whole current state of affairs, here denied having HIV which meant he did understand his condition and what was going on (all factors) so no capacity
-Re E 1993- need to understand the moral and social issues, force feeding, focus on narrow issues and ignoring parents meant she didnt undertand the broader issues
-Re L 1998- child didnt understand consequenecs as doctors hadnt told her so no Gillick competence, failure here was doctors (other peoples action can make you have more or less capacity)
- weighing all factors
-sufficient experience of the world
Re L 1998- 14 year old jehovas witness would have been able to cnsent if raised less insularly
-must weigh all the issues
FvF 2013- only focused one issue of veganism so couldnt weigh all issues and didnt have capacity
-cant be reiterating parents views
Re A- heavly influences by mother and reiterating her views
NHS trust v BK 2016- child objected to pain relied and meds, not competent as parrotting mums views
-fluctuating mental state
Re R 1992- not competent
parents consenting for Gillick competent children
the flack jacket- when a child becomes Gillick Competent parents does loose the right to consent, aslong as someone consents the actions will go ahead
-Re W 1992- jacket can only be used if it will promote the welfare of the child, PR holder or court can grant it
-Re M 1999- no need to determine Gillick comeptence if consent from parents + welfare of child as flack jacket is aleady active
no Gillick comeptence and parents decide incorrectly
-yates and other v great ormond street hospital for children NHS foundation trust and another 2017- NHS didnt want to treat ill child, parents did, parents found risky likely unseccessful treatement in america which moving child would likelt harm him, court denied treatment as parents no right to insist treatment that is not in the best interest of the child
-Alder hey childrens NHS foundation trust v evans and another 2018- hospital wanted to tune ventilator off for ill child, parents didnt want this, court allowed ventillation to be turned off
-Re M (declaration of death) 2020- brainstem death, parents disagreed as body still warm, court agreed with order to withdraw life support
parental liability-
-domestic violence, crime and vitims act 2004 sc5- causing or allowing death of child or vulnerable adult
-children and young person act 1933 sc1- offence to willingly neglect or treat a child in a way that exposes them to bodily injury or ill health
-R v sheppard 1981- wilful means deliberate
-R v senior 1899- objection to medicine, deliberately neglected
welfare principe still enaged in medical cases
-BC v EF 2017, order for child to be vaccinated, father said would take him then declined, would not be in best interest of child to be taken for vaccinations by stranger, so no vaccinations
the court siding with parents
-Re T 1997- transplant likely to succeed for dying baby, parents wanted to not have treated, court allowed no treated as to allow the parents to move on without intereference in their lives
-Raqeeb v Barts NHS foundation trust 2019- brain bleed, hospital wated to withdraw treatment, parents wanted to transfer to spain for treatment, court did not reject as spanish doctors were reasonable body of medical opinion and not degrading painful or burdensome treatment
when the parents was treatment but the doctors dont
-generally no right to force treament
-NHS trust v S 2017- court allowed doctors to turn off life support as parents had no right to demand specific treatment from hospital
-can apply to the courts for guidance/JR
-R v cambridge district health authority 1995- trust didnt want to do procedure due to price, court said cant compell treatment
forbidden treatments
-explicitly legislated against
-female genital mutilation act 2004
-debate about circumcision
best interests:
-bell v tavistock- can you consent a treatment against a best interest
-double flack jacket, both parent and child consent
