Consent for Medical Examination

 Except in emergency/urgent situations, no medical examination can take place without the consent of a person with parental responsibility or the child/young person if they have sufficient maturity to understand its implications. People giving consent should be made aware that photographs might be taken.

Consent to medical treatment of a child should normally be sought from someone who has parental responsibility.  Only one consent is required and the consent of the person with whom the child is living need not in cases of difficulty be preferred to that of others with parental responsibility.  The local authority has parental responsibility for children subject to an interim or full care order.

Efforts should be made to confirm this consent in writing; if this is not possible, the giving of consent should be recorded.

It is for the doctor to decide whether the child is capable of giving informed consent using the Fraser Guidelines. Where the child is not of sufficient understanding, the consent of a person with parental responsibility is required.

Children of 16 and over can give their own consent.

A young person with learning difficulties even if over 16 years, may not be able to give informed consent. In exceptional cases, a court order may need to be obtained.

In cases where parental consent is sought and refused, and where urgent treatment is not thought to be necessary, the medical examination should be delayed until an appropriate order is obtained by the Local Authority. All actions and decisions should be recorded in detail.

An examination or treatment of a child of sufficient age and understanding to give consent (ie deemed to be Gillick competent) may only proceed with the consent of the child even if the medical examination or any other assessment has been ordered by the court.

GOOD PRACTICE GUIDANCE:-

The Fraser guidelines state that before providing a service to under 16’s to which parents have not given consent the health professional should ensure that the following criteria are met:

1. The young person understands the advice being given.
2. The young person cannot be convinced to involve parents/carers or allow the medical practitioner to do so on their behalf.
3. It is likely that the young person will begin or continue having intercourse with or without treatment/contraception.
4. Unless he or she receives treatment/contraception their physical or mental health (or both) is likely to suffer.
5. The young person’s best interests require contraceptive advice, treatment or supplies to be given without parental consent.

The Fraser Guidelines criteria specifically refer to contraception. However the principles are deemed to apply to other treatments and procedures