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16 November 2018
Get to know the principles of parental responsibility with our quick guide.
Parental responsibility is not necessarily automatic for all parents.
A child's birth mother will usually have parental responsibility, as will fathers married to the mother at the time of birth of the child.
Unmarried fathers will only have automatic parental responsibility if:
Parental responsibility can also be held by adoptive parents, those appointed as a legal guardian or those given a residence order.
Additionally, when a child is subject to a care order, parental responsibility will be held by the local authority.
Parental responsibility can be an important factor in a number of situations involving the care and treatment of children or young people.
Parental responsibility may play a part in deciding whether you can treat a young patient, as well as who can give authority for a child to be treated.
You may need someone with parental responsibility to authorise treatment, but the GMC advises that all children should be involved as much as possible in decisions about their care and their views taken into account (0-18 years: guidance for all doctors). Some examples where parental authority may be needed might include:
Situations involving parental access to a child's medical records can vary, and may need to be assessed on an individual basis. The child's competence can also be an issue in such situations (see below).
Parental responsibility is frequently relevant in cases where a child is not deemed competent.
'Gillick competence' is a common term in medico-legal language, and refers to a young person under 16 with capacity to make any relevant decision. Usage stems from the case of Gillick vs West Norfolk and Wisbech, wherein the House of Lords ruled that the child in question could be given contraceptive advice and treatment without her parents' knowledge or consent. As a result, children with capacity are now termed 'Gillick competent'.
Many cases involving parental responsibility will only require you to deal with one person, but some types of treatment require the agreement of both parents (such as male circumcision for religious reasons).
Parents may not always agree on decisions involving their children, in which case you may be put in a difficult situation. In these cases:
This guidance was correct at publication 16/11/2018. 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.
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