Safeguarding, Children and the Law Flashcards
How is the mental capacity Act relevant to children?
individuals older than 16yrs are presumed to have capacity unless proven otherwise
In children under 16yrs the principles of Gillicks competence should be used - this is a common law.
What is the Gillick test?
Used to establish if children under 16yrs can consent to proposed treatment.
Must have full understanding and involved in treatments:
1. Purpose
2. Nature
3. Likely effects and risks
4. Chances of success
5. Availability of other options.
What happens if a child does not pass the Gillick test related to competence?
Considered pre-comptent - the the consent of a parental responsibility or courts is needed.
What is the key difference between competence and capacity?
Competence - normal development of child within realm of psychology
Capacity - impairment or distrubance in functioning or brain within the realm of psychiatry.
What is Gillick Competence?
Principle to judge capacity in children to consent to medical treatment.
Consent is valid if given voluntarily.
Competence is time and decision specific
Part of UK common law
No lower age limit
What is the purpose of the Fraser Guidelines?
Apply specifically to contraceptive advice, STIs and termination of pregnancy.
Relate to judgement of Gillick case
Assess if child able to have competency to make own decisions against/without parents knowledge.
What criteria must be met in order to match the Fraser Guidelines?
- Understand advice
- Cannot be persuaded to inform parents or allow health team to inform parents
- Likely to continue to have sexual intercouse with or without contraceptives
- Physical or mental health will suffer without treatment
- Best interests to provide treatment without parental consent.
What should happen is a safeguaring concern is raised for a child under 16yrs?
Must always be reported to safeguarding - the child should be informed first if appropriate
This is regardless of whether they have Gillick Competence or not.
How to competence guidelines apply to children under 13yrs?
Very rare for a child under 13yrs to make decisions without parents consent - although Fraser/Gillick has no lower age limit
Any sexual activity is illegal as under 13yrs considered by law not to be able to consent so if active must be acted on.
How do laws of competency apply to children between 13-15yrs of age?
Gillick Competence often comes into play
Very variable developmental stage - requires an individualised assessment.
Often varies based on decision severity.
How do laws of competence apply to children aged 16-17yrs?
Presumed in law to have capacity unless reason to doubt (MCA)
However, refusal of treatment may be overridden by person with parental responsibility or by courts in ground of best interest - if child deemed Gillick competent and refused the courts should be involved.
How do competency laws apply to children over 18yrs+?
Asssumed adulthood by law (childrens Act 1989) - presumed to be competent.
Mental Capacity Act and the Mental Health Act are in place.
Who has parents responsibility over a child?
- Mother from birth
- Father if married to mother, listed on birth certificate, PR agreement with mother or court.
- Same sex partners if civil partners at time of fertility treatment, jointly register the birth or have a PR agreement.
What are the roles within having parental responsibility over a child?
- Provide a home
- Protect and maintain a child
- Disciplining
- Choosing and providing education
- Agreeing to child medical treatment
- Naming child and agreeing to change in name
- Looking after the child property.
How does parental disagreement apply to consenting to a child medical treatment legally?
- The consent of one person is suffieicnt to start treatment (Chldrens Act 1989)
- Good practice to involve of especially in important/irreversible treatment such as circumcision and vaccination
- If parents unable to reach a mutual agreement informally legal advice is needed to determine ti the courts are needed to determine best interests of the child.
What are guidlines relating to consent in receiving emergency treatment of a child?
In a true emergency action may be taken to save the life of the child and prevent further deterioration.
Emergency decision or pre-emptive court decision should then be sought for further emergency treatment if foreseeable.
Without court involvement only that immediately necessary to preserve life is allowed to be given.
How does doctor/parents opinion tend to hold up in courts?
Courts tend to agree with medical decisions as long as this appears to be in the child best interest.
‘Parents are free to make martrys of themselves but not their children’.
What are the four main categories of abuse that a child may be victim to?
- physical abuse
- Emotional abuse
- Sexual abuse
- Neglect
What clinical assessment should be held when a suspected abuse case for a child is raised?
Referal to child protection medical assessment includes:
Comprehensive detailed medical and social history
Comprehensive physical examination
Medical photography
What investigations are often done for a child when abuse is suspected?
- Bloods - coagulation disorders, bone disease (rule out organic cause)
- Skeletal survery
- CT head
- Opthalmology assessment - for retinal haemorrhages (shaken babies)
What are the typical non-abusive bruising patterns in a child?
Forehead/nose
Shins
Lower back
Back of head.
What are the typical abusvie brusing patterns in a child?
The soft areas - tummy, bum cheeks, thighs
Arms
Side of heads/ears
On chest or back.
What multiagency should be invovled in a safeguarding investigation relating to a child?
Education
Police
Healthcare
Social services
