For immediate release: Wednesday, 21 November 2012
Doctors are reminded that only those with parental responsibility – or authorisation from a parent – can consent to treatment in children who lack capacity, unless in an emergency.
The issue of who can consent for treatment in children can, in certain situations, be a difficult one to judge and UK-wide medical defence organisation MDDUS has dealt with a number of calls from members seeking advice on this topic.
“When a child needs to consult a doctor, it is likely their parent will be present to discuss and consent to any necessary treatment,” says MDDUS medical adviser Dr Mary Peddie.
“But what if a grandparent or childminder is the one who turns up in your consulting room seeking help for a child’s health problem? The number of calls we receive on this subject suggests that it is not always easy for a doctor to judge who can consent for children not yet old enough to make their own health decisions.
“The basic principle is that only a person with what is known as ‘parental responsibility’ can consent to a child’s medical treatment. In an emergency situation where there is no one with parental responsibility available to consent, the doctor should act in the child’s best interests.”
By law, a mother always has parental responsibility for her child but not all fathers do. In relation to children born after December 1, 2003 (England and Wales), April 15, 2002 (Northern Ireland) and May 4, 2006 (Scotland), both biological parents have parental responsibility if they are registered on a child’s birth certificate.
“For children born before these dates, the biological father will only automatically acquire parental responsibility if the parents were married at the time of the child’s birth or at some time thereafter,” says Dr Peddie.
“If the parents have never been married, only the mother automatically has parental responsibility, but the father may acquire that status by order or agreement. Parents do not lose parental responsibility if they divorce or separate, but they do in cases where the child is given up for adoption.
“A person also holds parental responsibility if they are the child’s legally appointed guardian or have been granted this right by a court. Exceptions to the rule of parental responsibility include carers authorised by a parent and emergency situations where essential treatment can be provided to preserve life or prevent serious deterioration.”
GMC guidance 0-18 years: guidance for all doctors states: “People without parental responsibility, but who have care of a child, may do what is reasonable in all the circumstances of the case to safeguard or promote the child’s welfare. This may include step-parents, grandparents and childminders.”
The guidance also states that consent from people who are caring for a child such as grandparents and childminders – but do not have parental responsibility – can be accepted “if they are authorised by the parents”.
“Such consent does not need to be in writing and the healthcare professional does not need to consult the parents unless there is cause to believe the parents’ view would differ significantly,” adds Dr Peddie.
“So while there is no specific agreement between parents and a third party in any given situation, the third party can give consent providing it is in the child’s best interests. An example of this would be a teacher accompanying a pupil to A&E for urgent treatment following an accident at school.
“Doctors should contact their medical defence organisation if they have any doubts about consenting for children.”
For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email firstname.lastname@example.org.
Note to editors
MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to www.mddus.com.
This page was correct at the time of publication. Any guidance 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.