Consent and capacity: issues for paediatric anaesthesia

Abstract

Abstract: Learning objectives: By reading this article, you should be able to: • Describe the assessment of mental capacity. • Explain what is meant by the term ‘Gillick competence’. • Appreciate the current legal uncertainty with respect to competent refusal by young persons. Describe the principles of lawful restraint to facilitate treatment.

Key points: A minor is ‘Gillick competent’ once they have reached sufficient maturity to understand fully the treatment proposed and its consequences. Once Gillick competent, they can consent to medical treatment. • Parents cannot veto a competent minor’s consent to treatment. • The laws governing a competent minor’s refusal of treatment that is considered to be in their best interests are complex and uncertain. Doctors faced with this scenario would be wise to seek legal advice before proceeding. • The rights of parents are qualified by the need to protect the health of the child. • Physical or chemical restraint to facilitate treatment is legal provided that the restraint is necessary and proportional to the harm being prevented.