We have placed cookies on your device to help make this website better.
If you choose to customise the site it will help you to find the most relevant content for your needs. You will still be able to access all content on the site.
0800 716 646
7 July 2017
Assessing the best interests of children who are too young to make decisions for themselves is complex, particularly where there is disagreement between those with parental responsibility.
A child's birth mother will usually hold parental responsibility. If the child's father is not married to the mother, his role may be more complicated to determine.
Read our guide for further detail, or see appendix 2 of the GMC's 0-18 years: guidance for all doctors.
The details of consent and refusal for medical treatment vary in different UK jurisdictions for older children, but for young children the approach is uniform. In most clinical scenarios, the authority of just one parent with parental responsibility will be sufficient. When a child attends a medical appointment they are usually accompanied by one parent, and in most situations it will be reasonable to assume that the other parent would be in agreement about the proposed course of action.
There may be situations where the child's parents are known to disagree, or where you believe they are likely to disagree – for example, if one parent opposes a particular treatment on religious grounds, or objects to specific immunisations.
Doctors may need to do their best to assist the parents in resolving their conflict and reaching a consensus before starting treatment.
If the dispute cannot be resolved informally, and you think treatment is in the child's best interests, seek legal advice about whether to apply a court ruling as to whether treatment is lawful.
The Department of Health has stated: 'Consent given by one person with parental responsibility is valid, even if another person with parental responsibility withholds consent. However, the courts have stated that a 'small group of important decisions' should not be taken by one person with parental responsibility against the wishes of another, citing in particular non-therapeutic male circumcision and immunisation. Where persons with parental responsibility disagree as to whether these procedures are in the child's best interests, it is advisable to refer the decision to the courts'.
Section 24:10 of the Department of Health's guidance recommends that a court ruling should be sought as early as possible where there is a disagreement over withdrawing life-sustaining treatment.
The GMC has also issued guidance on withdrawing life-sustaining treatment in neonates, children and young people and the resolution of disputes. Regarding disputes between adults with parental responsibility for a sick child, it recommends considering the following to help resolve the dispute:
If after taking these steps there is still disagreement, seek legal advice on applying to the court for an independent judgment.
In an emergency where there is no time to obtain authority or resolve conflicts, doctors should act quickly to provide appropriate immediate treatment to safeguard the child's life and prevent serious deterioration of their condition.
If the parents are available, their authority should be obtained, but if they cannot be contacted immediately, the doctors should proceed in the best interests of the child.
This guidance was correct at publication 07/07/2017. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.
Be the first to comment
© 2018 The MDU
We have detected you are in and some website content may have been personalised to be more relevant to you.
You can change your region setting here or at the top of the page.