Young Children Flashcards
Who can give consent?
1) Child
2) Those with parental responsibility
3) Those with ‘care for a child’ (e.g. teacher)
4) Court
*Unless it is an emergency, health professionals need someone’s consent before they can examine, investigate or treat a child
Parental responsibility
- Those with parental responsibility can consent to (or reject) treatment on behalf of the child
- Scope of parental responsibility is limited by the BEST INTEREST of the child
Who has Parental Responsibility
1) Birth mother
2) Biological father
- If married to birth mother at the time of conception, birth or currently
- If a written agreement is made with birth mother
- Court order
- Jointly registering the birth
3) Civil partners
4) Non-civil partners
- Apply for PR if parental agreement made
- Jointly registering the birth
- Becoming a civil partner of other parent and making PR agreement
5) Step-parents
6) Local authority
7) Legal guardian
8) Adoption agency
9) Anyone with a residence order
Important points to note
- Court orders can overrule parents’ refusal for treatment
- Unilateral consent is sufficient for treatment to go ahead (although attempts to reach mutual consent should be made)
- If parents and healthcare professionals have differing POVs on treatment and cannot be resolved –> Apply to Court
When is consent not needed?
1) Emergencies
- GMC states that ‘you can provide emergency treatment without consent to save the life of, or prevent serious deterioration of health of, a child or young person’
- Emergencies should be construed conservatively and do just enough to avert an immediate crisis
2) Abandonment by parents
3) Abuse by parents
- Should follow child safeguard protocols
Gillick competence
-A term used in medical law to decide if a child <16 years old can consent to their own treatment WITHOUT parental permission or knowledge
Young people aged 16-17 years old
- Has presumed capacity
- Can consent to their own treatment
- BUT CANNOT REFUSE life saving treatment
Young people <16 years old
- If Gillick competent, they can:
1) Consent to own treatment
2) CANNOT REFUSE life saving treatment
If not Gillick competent:
1) CANNOT CONSENT to own treatment
2) CANNOT REFUSE life saving treatment
Need a parent/proxy to act in their best interest and give consent
Accessing Gillick Competence
1) Willingness to make a choice
2) An understanding of the nature and purpose of the proposed intervention
3) An understanding of the risks and side effects associated with the proposed intervention
4) An understanding of any alternatives to the proposed intervention and the risks associated with them
5) Freedom from undue pressure
Fraser Guidelines
-Specifically for child <16 years consenting for sexual health advice, treatment and contraceptions
Child needs to:
1) Understand professional advice
2) Cannot be persuaded to obtain parental consent
3) Likely to begin/continue sexual activity without treatment
4) Without treatment, young person’s physical and mental health is at risk, so is likely to suffer
5) In the young person’s best interest to be treated without parental consent
Legal age for consenting to sexual intercourse = 16 years
< 13 years is statutory rape and a criminal offense –> MUST REFER TO CHILD PROTECTION SERVICES
Confidentiality of Minors
Competent minors (16-17 years old or Gillick competent <16 years) are entitled to the same confidentiality as adults
Children Act 1989
‘Welfare’ of child includes:
1) Ascertaining feelings and wishes of child
2) Child’s emotional and physical needs
3) Any likely changes to family circumstances
4) Any harm suffered or likely to suffer from
5) Age, gender and cultural background of child
6) Other factors in child’s background
GMC Guidance
States that:
1) ‘Doctors must safeguard and protect the health and well-being of children and young people. Well-being includes treating young people as individuals and respecting their views, as well as considering physical and emotional welfare’
2) ‘Doctors should always act in the best interest of a child’
