When can children give consent to treatment?

The law states that any person with the capacity to consent can give consent to examination and treatment.

In this context capacity relates to the ability of the patient to understand and retain information relating to their condition and the proposed treatment.

Practitioners need the knowledge and confidence to make the right decisions with regard to receiving consent from children.

The law is different between Scotland and the rest of the UK for consent from children.

Presumed Capacity to Consent

In England, Wales and Northern Ireland any person over the age of 18 years is presumed to have capacity to consent unless it is established that they lack consent.  In Scotland anyone over the age of 16 years is presumed to have capacity to consent.

Children aged 16-17 years in England, Wales and Northern Ireland

Children aged 16-17 years are able to consent to treatment unless they lack capacity.  The two test phrases are that:

  • They have sufficient maturity or intelligence to enable them to understand what is involved in the proposed treatment
  • a lack of maturity means that they feel unable to make the decision for themselves

In the osteopathic context they need the maturity to understand the condition as you have explained it, the proposed treatment plan and the risks involved in treatment.

Children under 15 years old

In Scotland a medical practitioners approval of capacity to consent is needed for a child aged 15 years or younger.

In England, Wales, and Northern Ireland if the child has sufficient maturity and intelligence to understand what is involved in treatment and examination they may give their own consent.

In the context of osteopathy and manual therapy it is best practice to have an adult present during treatment.

Who can give consent for a child?

Consent needs to be given by someone with ‘parental responsibility’ for the child.  There are specific rules about who has parental responsibility in the different countries and depending on when the child was born.  If you are in doubt, check the rules for your region in the GOsC Consent Documents or the information below.

The child’s mother can always give consent for the child unless the child has been legally removed.  Whether a father has parental responsibility depends on whether the parents were married when the child was born and the year when the child was born.

A key fact to take away is that the child should be accompanied by a parent – not any other relative including grandparents, or childminders etc.

Parental responsibility:

Northern Ireland

Children born to parents married at time of conception or birth

The child’s parents.

Children born to unmarried parents before 15 April 2002

The child’s mother.

The child’s father only if parental responsibility is subsequently acquired via a court order or a parental responsibility agreement, or the couple subsequently marry.

 Children born to unmarried parents on or after 15 April 2002

The child’s parents if they jointly registered the child’s birth, so that the father’s name appears on the birth certificate.

The child’s mother.

The child’s father only if parental responsibility is subsequently acquired via a court order or a parental responsibility agreement, or the couple subsequently marry.

Children born on or after 6 April 2009

A step-parent (i.e. a person who is married to or a civil partner of a child’s parent) if the Court makes an order that he or she has parental responsibility.

The child’s legally appointed guardian.

A person in whose favour the Court has made a residence order concerning the child.

A Health and Social Services Trust designated in a care order in respect of the child).

A Health and Social Services Trust which holds an emergency protection order in respect of the child.

Children born on or after 6 April 2009 by IVF

Where the child’s mother was in a same sex relationship (but not a civil partnership) at the time of the IVF, that parent shall acquire parental responsibility for the child:

  1. a) if she is registered as a parent of the child
  2. b) via a parental responsibility agreement or
  3. c) by order of the Court.

 

Scotland

Children child born before 4 May 2006

If the child’s mother and father were married to each other at the time of birth (or got married later), then both parents.

If the child’s mother and father are not married, then the child’s mother only.

Children born on or after 4 May 2006

The child’s mother.

The child’s father, if he was married to the mother at the time of birth (or got

married later). Both parents provided that they have registered the child’s birth together.

The child’s father, if he fills in a form called a Parental Responsibilities and Parental Rights Agreement (PRPRA) provided the mother agrees, or if granted parental responsibility and rights by the Court.

Other people (such as grandparents, stepparents, aunts or uncles) if they are given parental responsibility and rights by a Court.

In relation to children born on or after 6th April 2009, parental responsibility may be exercised by the following persons in addition to those mentioned on the left.

Where the child’s mother was in a civil partnership at the time of treatment for assisted reproduction (e.g. IVF), the other party to the civil partnership is to be treated as a parent of the child.

Where the child’s mother was in a same sex relationship (but not a civil partnership) at the time of IVF, if the woman is registered as a parent of the child she will have parental responsibility.

England

In relation to children born before 6 April 2009

– The child’s mother

– The child’s father, if he was married to the mother at the time of birth

– The child’s father if (although not married to the mother at time of birth), he has subsequently obtained a parental responsibility order from the Court or has subsequently married the mother of their child, or if he jointly registered the birth with the child’s mother (from 1 December 2003)

– The child’s legally appointed guardian

– A person in whose favour a Court has made a residence order concerning the child

– A local authority designated in a care order in respect of the child

– A person who has been appointed by the Court as a guardian for a child where there is no parent with parental responsibility.

 In relation to children born on or after 6th April 2009, parental responsibility may be exercised by the following persons in addition to those mentioned above

– Where the child’s mother was in a civil partnership at the time of treatment for assisted reproduction, e.g. IVF, the other party to the civil partnership is to be treated as a parent of the child.

– Where the child’s mother was in a same sex relationship (but not a civil partnership) at the time of the IVF, the other woman will be a legal parent if the mother consents.

Leave a Reply

Your email address will not be published. Required fields are marked *