The scene

A GP called the MDU advice line after seeing an 8-year old girl in his surgery earlier that day, who had attended along with her stepfather. The child was epileptic and her stepfather wanted to discuss her regular medication. The mother of the child had sadly died a month earlier, and the stepfather, who had been married to the child's mother, had been caring for the child since her death.

The child was not Gillick competent and the child's biological father had been estranged from the family for many years. During the consultation it emerged that the stepfather did not have parental responsibility for the child.

The GP wanted advice on how he could ensure he gained appropriate consent for the continuing treatment of this child, in the absence of an individual with parental responsibility.

MDU advice

The adviser explained that in the immediate situation, if urgent treatment was needed, the doctor should do what is considered to be in the best interests of the child.

For non-urgent treatment the doctor would need the consent of one person with parental responsibility to treat the child, which would include providing medication as well as interventional procedures. The GP would need to establish who has parental responsibility, and the adviser suggested finding a suitable time to sensitively discuss the situation with the stepfather and encourage him to address the issue formally.

The adviser explained that the biological father of the child may have parental responsibility, and that the stepfather may be able to acquire parental responsibility for the child either through an agreement with the biological father, or through the courts. If the biological father retains parental responsibility, he could also authorise the stepfather to attend any appointments with the child in his place. However, this may not be considered sufficient if any contentious or important issues arose that required parental consent.

The adviser went on to suggest that one option might be to involve social services, with the stepfather's consent, to help him sort out the issue of parental responsibility. This may also provide the family with some additional support during a difficult time, given that the stepfather is dealing on his own with a young child with long-term health needs, as well as dealing with his wife's death.

The outcome

The GP planned to arrange a further appointment with the stepfather to discuss any support he might need as a result of his recent bereavement, and to encourage him to explore the options around obtaining parental responsibility for his stepdaughter. With the step-father's consent, the GP contacted social services to offer on-going support to the family.

Parental responsibility and consent dilemma

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