This article considers the requirements for Gillick competence, it highlights the factors that must be considered when determining whether a child is competent to give consent to treatment. In this article, we explore the implications of adopting 'Gillick competence'drawn from healthcare lawas the relevant test of sufficient maturity in the data protection law context. Failure to obtain the co-operation of the children will make it very difficult to safely give the MMR. Gillick competency and Fraser guidelines Balancing children's rights with the responsibility to keep them safe from harm . Especially useful fo. People also read lists articles that other readers of this article have read. the Family Law Reform Act 1969 states: "The consent of a minor who Care Quality Commission. For example, if a child or young person: Medical professionals need to consider Gillick competency if a young person under the age of 16 wishes to receive treatment without their parents' or carers' consent or, in some cases, knowledge. The ethics of adolescent medical decision-making is a fraught area for medical ethics because it deals with the threshold boundaries between childhood and adulthood and Gillick adds a burden upon children and adolescent patients that is unwarranted and through which damage is . Help for adults concerned about a child A number of enforcement measures are available to the court but these are at the discretion of the judge who will again need to balance the best interests of the child against the impact of any enforcement measure. true /ColorSpace 8 0 R /SMask 13 0 R /BitsPerComponent 8 /Filter /FlateDecode strictly prohibited. Both Gillick competency and Fraser guidelines refer to a legal case from the 1980s which looked at whether doctors should be able to give contraceptive advice or treatment to young people under 16-years-old without parental consent. Fraser guidelines are used specifically for children requesting contraceptive or sexual health advice and treatment. We use cookies to improve your website experience. Gillick competence is the principle we use to judge capacity in children to consent to medical treatment. The young person will understand the professionals 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; and. practitioner should be consulted for diagnosis and treatment of any and all medical conditions. The following information looks at how this can be applied in practice. In Northern Ireland the Department of Health provides consent guides for healthcare professionals (Department of Health, 2003). Oxbridge Solutions Ltd receives funding from advertising but maintains editorial Similar provision is made in Scotland by the Age of Legal Capacity (Scotland) Act 1991. This is known as being Gillick competent. Where a person under the age of 16 is not Gillick competent and therefore is deemed to lack the capacity to consent, it can be given on their behalf by someone with parental responsibility or by the court. Oxbridge Solutions Ltd. Health professionals must be confident in assessing a child's Gillick competence in order to ensure that the child's rights are respected, this requires the health professional to evaluate the child's maturity and intelligence when seeking consent to immunization. The standard is based on the 1985 judicial decision of the House of Lords with respect . to treatment to anyone aged 16 to 18. They are named after one of the Lords responsible for the Gillick judgement but who went on to address the specific issue of giving contraceptive advice and treatment to those under 16 without parental consent. You should always encourage a child to tell their parents or carers about the decisions they are making. There are no potential conflicts of interest. Gillick competence is used to assess a child's capability to make and understand their decisions in a wider context. ; If under 13, is the patient engaging in sexual activity? Consent for the medical treatment of patients under 18 years of age is generally provided by parents. The Gillick competence doctrine is part of Australian case law (see, e.g., DoCS v Y [1999] NSWSC 644). The rule in Gillick must be applied when determining whether a child under 16 has competence to consent. It is not just Learn how your comment data is processed. % A child of 15 years or above would normally be expected to have sufficient maturity, intelligence and understanding to . the young person cannot be persuaded to inform their parents or carers that they are seeking this advice or treatment (or to allow the practitioner to inform their parents or carers). National Society for the Prevention of Cruelty to Children. Although a question of private law rather than state intervention into family life, the courts are still obliged to follow the provisions of the Children Act 1989 and consider the best interests of the welfare of that child. When assessing Gillick competence for immunization, a health professional has to decide whether the child is or is not competent to make that particular decision. In F v F [2013] the High Court ordered that sisters aged 11 and 15 y must receive the MMR vaccine.Citation11 Mr Justice Sumner made it clear that although the case concerned a dispute between parents his only concern was for the best interests of the welfare of the children. It is considered good practice for doctors and other health professionals to follow the criteria outlined by Lord Fraser in 1985 in the House of Lords' ruling in the case of Victoria Gillick v West Norfolk and Wisbech Health Authority and Department of Health and Social Security. The form is based on the meaning of 'capacity' in section 14 of the Mental Health Act 2016. However, where parents are in dispute with each other over an issue of parental responsibility, that can include disagreement over immunization, then if negotiation fails they can go to court to resolve the matter. Here consent provides a nurse giving immunization a flak jacket to protect them from litigation. A child who is deemed Gillick competent is able to prevent their parents viewing their medical records. Any other browser may experience partial or no support. The case went to the High Court in 1984 where Mr Justice Woolf dismissed Mrs Gillick's claims. If the conditions are not all met, however, or there is reason to believe that the child is under pressure to give consent or is being exploited, there would be grounds to break confidentiality. When assessing Gillick competence for immu-nization, a health professional has to decide whether the child is or is not competent to make that particular decision. At 11 and 15 y the judge was obliged to consider whether they were Gillick competent, in that they had the maturity and intelligence to refuse the MMR vaccine. Sexual activity with a child under 13 should always result in a child protection referral. The result of Gillick is that in England today, except in situations that are regulated otherwise by law, the legal right to make a decision on any particular matter concerning the child shifts from the parent to the child when the child reaches sufficient maturity to be capable of making up his or her own mind on the matter requiring decision. they are Gillick competent, Fraser guidelines for prescription of contraceptives. Hum Vaccin Immunother. It is argued that the relatively broad usage of the test of Gillick competency in the medical context should not be considered applicable for use in research. Brief guide: capacity and competence to consent in under 18s (PDF). Later she had a total of 10 children. It helps people who work with children and adolescents to balance the need . The case is binding in England and Wales, and has been adopted to varying extents in Australia, Canada, and New Zealand. When you are assessing Gillick competency if you have any concerns about the safety of the young person you should check whether previous child protection concerns have been raised, and explore any factors that could put them at risk of abuse. Abstract. =g|2Gu %$kOnvKTLl~RKv(~x$zz-` fE2y1 fi+]TMjaULT:i m}jKUX*K-m}jy. The House of Lords focused on the issue of consent rather than a notion of parental rights or parental power. It was found that Gillick did not apply directly to the issues before the court in this case but there is useful commentary and discussion in the judgement regarding the use of Gillick competence. Gillick competence is a functional ability to make a decision. The understanding required for different interventions will vary, and capacity can also fluctuate such as in certain mental health conditions. For more information, please visit our Permissions help page. The courts do not adopt an unquestioning recommendation of immunization but give careful consideration to each case on its facts. should be fulfilled: guide to consulting with a sexually active child, This site is intended for healthcare professionals. The court views immunization as a voluntary process that both parents are entitled to be consulted on. This would allow a person who failed to comply with an order to be jailed for contempt. > Find out more about the Library and Information Service. Under the Family Proceedings Rules 1991 a penal notice may be attached to a specific issues order. As cited in Childrens Legal Centre (1985) Landmark decision for childrens rights. Microsoft is encouraging users to upgrade to its more modern, children Gillick competence = assesses whether a child is competent Patients between the ages of 16 to 18 are assumed to be competent and can give consent If a child passes the Gillick test, he or she is considered Gillick competent to consent to that medical treatment or intervention. x0 ; there . the young person understands the advice being given. Lord Fraser stated that a doctor should always encourage a girl aged under 16 to inform her parents or carers that she is seeking contraceptive advice (or allow the doctor to inform the parents or carers on her behalf). Children under 16 can consent to medical treatment if they understand what is being proposed. Fraser guidelines, on the other hand, are used specifically to decide if a child can consent to contraceptive or sexual health advice and treatment. 2(1) and 3(1) Mental Capacity Act 2005. Did you know that with a free Taylor & Francis Online account you can gain access to the following benefits? it is in the young person's best interests to receive the advice, treatment or both without their parents' or carers' consent. Immunization is voluntary and generally it is for those who have parental responsibility for a child or children who are Gillick competent to decide on immunization. Children who are younger than this may be mature enough to decide for themselves and not want their parents involved, which will . If a child does not pass the Gillick test, then the consent of a person with parental responsibility (or sometimes the courts) is needed in order to proceed with treatment. Obtain permissions instantly via Rightslink by clicking on the button below: If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. 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