Rights and Interests of Children
General Medical Council (UK) guidance:-
"You should involve children and young people as much as possible in discussions about their case, even if they are not able to make decisions."
"A young person's ability to make decisions depends more on their ability to understand and weigh up options, than on their age."

There are three main legal areas that govern the legal rights of children and protect their interests. These include:

  • The Children Act 1989
  • Family Reform Act 1969
  • Common Law: Gillick vs.West Norfolk and Wisbech Area Health Authority

(Scotland has different Acts)

The Children Act 1989
This Act outlines that the Child's welfare is of utmost importance and their views must be respected in the appropriate circumstances. It is a list of general principles that one should keep in mind when dealing with cases involving children so as to maximally promote and protect their general welfare and to guide actions that are in their best interest.

Although aimed at court decisions, is useful for medical practice, in particular:-

  • "A court shall regard in particular to the ascertainable wishes and feelings of the child concerned"
  • "His physical, emotional and educational needs."
  • "The likely effect on him of any change in his circumstances"
  • "Any harm which he has suffered or is at risk of suffering"
  • "How capable parents and other people are in meeting the needs of the children"
  • "The age, sex and background, and any characteristics which the court considers relevant."

It also outlines exactly who has parental responsibility or guardianship.

The Act allows anyone with parental responsibility to act alone (the consent of 1 parent is necessary)

Family Law Reform Act 1969
Those who are 16 years old or above has the same legal ability to consent to any medical, surgical or dental treatment as anyone above 18, without the consent from his parent or guardian.

This does NOT mean that they have a right to refuse treatment (see below).

Right to Refuse Treatment
  • Those who are under 18 years old who has capacity and refuses therapeutic treatment, as long as there is one consenting parent or guardian (even if the other refuses), the medical staff can proceed.
  • This is because it is done with the best interest of the child in mind.
  • However if the intervention is non-therapeutic (i.e. male circumcision on religious grounds) and both parents disagree, then a court ruling should be sought
  • If the treatment/investigation is non-urgent but still in the best interests of the child the clinician can request a "specific issue order" under the Children's Act 1989.
  • Once a minor is made ward of the court, then no major treatment can be given without permission of the court.
  • Wheeler R.(2006) Gillick or Fraser? A plea for consistency over competence in children: Gillick and Fraser are not interchangeable. British Medical Journal , 332 (8 April): 807.
  • Gillick v West Norfolk & Wisbech Area Health Authority [1985] UKHL 7 (17 October 1985) from the British and Irish Legal Information Institute (BAILII) website.
  • Regina v howard (1965) Lord parker C.J.
  • Sexual Offences Act 2003