Children (minors)
The focus of this session will be based upon those persons below the threshold of
adulthood i.e. 18 years and will consider who can give consent for their treatment
(or non treatment)
Rights and obligations of young people
No specific age where citizens gain full rights
Allowed to take on rights as citizens mature and develop
Many on health protection grounds BUT often piecemeal and arbitrary based on age
Varying ages
Alcohol – can enter bar at any age with adult, drink in private at five, enter a bar
alone at sixteen and buy soft drinks, buy beer cider and wine with meal if with adult
at 16, buy and drink alcohol in a bar at 18
Employment – unlawful until 14 then light work (e.g. a paper round)
Sex – Age of consent now 16 whether heterosexual or homosexual since Sexual
Offences Act 2003
Criminal liability – Criminally liable at 10 but cannot be placed in adult prison until
age 21
Kennedy & Grubb
Children go through three stages to becoming an autonomous adult
Child of tender years
Gillick competent child
16 & 17 year old child
There are a number of issues then as to consent/refusal of treatment by the health
profession
Child of tender years
Relies on a person with parental responsibility consenting to care and treatment
In Re M (A Child) (Refusal of Medical Treatment) [1999] Justice Johnson held that no
minor child is a wholly autonomous person.
o Although children under sixteen with sufficient maturity and intelligence can
give a valid consent to treatment under the rule in Gillick and a child over
sixteen can consent under the provisions of section 8 of the Family Law
Reform Act 1969 a person with parental responsibility can also give a valid
consent on behalf of the child.
Parental Responsibility
1
, SHN2004 (Acute Care) – Parental Responsibility
The relationship between a child and parent was formalised in the Children Act 1989.
Parental responsibility is defined as all the rights duties powers responsibility and
authority which by law a parent of a child has in relation to the child and his property
(Children Act 1989, section 2).
o The right/power to make most of the decisions in the life of the child
diminishing as the child gets older and takes on more personal responsibility
These are not specified in the Act.
It empowers a person to make most decisions in a child’s life including consenting to
medical treatment on the child’s behalf.
Parental responsibility may be shared and generally decisions about a child can be
made independently.
In most cases you only need the consent of one person with parental responsibility
to proceed with treatment.
Who has parental responsibility
o Parental responsibility is conferred automatically on
The (birth) mother of the child and
The father if he was married to the mother at the time of the birth
(Children Act 1989, section 2).
If unmarried parents subsequently marry then the child’s father gains
parental responsibility for his children (Family Law Reform Act 1987,
section 1).
The Children Act 1989 was amended in December 2003 to allow
unmarried natural fathers to have automatic parental responsibility if
they become registered as the child’s father under any of the birth
registration statutes from that date.
Acquired Parental Responsibility
o If a father is not married to his child’s mother and was not registered as the
child’s father after December 2003 then he may still acquire parental
responsibility under an agreement with the mother or by order of the court.
o Other people may also acquire parental responsibility.
o Those in possession of:
an emergency protection order (most applied for by a LA but can be
another) or
care order (LA’s)
o have parental responsibility for the duration of the order.
o A person in possession of a residence order also acquires parental
responsibility (Children Act 1989, section 8).
A residence order generally settles where a child shall live.
The courts also grant residence orders where the child’s living
arrangements are settled to allow a person to obtain parental
responsibility.
2
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