Judges overrule NHS trust in landmark consent case
Judges overrule NHS trust in landmark consent case
Children as young as 10 had been allowed to consent to experimental puberty-suppressing treatment
An English NHS trust's Gender Identity Development Service (GIDS) had been prescribing puberty blockers to children as young as 10 suffering from gender dysphoria, a condition where persons experience distress because of a mismatch between their perceived identity and their sex at birth.
The claimant brought a judicial review in the High Court, claiming that children and young persons under 18 do not have the competence to consent to such treatment.
The court held that:
"A child under 16 may only consent to the use of medication intended to suppress puberty where he or she is competent to understand the nature of the treatment. That includes an understanding of the immediate and long-term consequences of the treatment, the limited evidence available as to its efficacy or purpose, the fact that the vast majority of patients proceed to the use of cross-sex hormones, and its potential life changing consequences for a child. There will be enormous difficulties in a child under 16 understanding and weighing up this information and deciding whether to consent to the use of puberty blocking medication. It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers. It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers.
See summary judgment below.
For the full judgment click here.
R-on-the-application-of-Quincy-Bell-and-A-v-Tavistock-and-Portman-NHS-Trust-and-others2020-EWHC-3274Admin
Healthcare charity Consent wants to hear from you
Have you ever experienced conflict with medical professionals over your child’s healthcare?
Informed consent is a principle that empowers parents to make educated and informed decisions over their children’s health and medical care.
Your choices can sometimes lead to conflict with health professional who disagree with your decision. While they are required to remain respectful towards you, this does not always happen.
You may have experienced conflict around birth choices, vaccination choices, managing medication, or even managing fevers. If so, we want to hear from you.
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About Consent
Consent was established in response to growing demand from parents to educate on matters of valid consent in healthcare and to promote mutual understanding between parents and healthcare professionals
Our mission is to:
- educate parents and medical professionals on law, policy, professional standards and best practice relating to parental rights and informed consent in the care and treatment of children
- provide support to parents in making decisions relating to their child’s care and treatment
- promote understanding of parental rights and informed consent between medical staff, social workers, parents and other relevant persons
Does the UK use implied consent for vaccinations in schools?
Misunderstandings have arisen as a result of the 2014 WHO document “Considerations regarding consent in vaccinating children and adolescents between 6 and 17 years old”
The document states clearly:
Consent is the principle wherein individuals must give their permission before receiving a medical intervention or procedure. According to the laws and regulations in place in most countries, consent is required for a range of medical interventions or procedures, from a simple blood test to organ donation, and including vaccinations. In only very few, well-described circumstances, such as life-threatening emergencies, may consent be waived. Consent derives from the principle of autonomy and forms an important part of medical and public health ethics, as well as international law*. To be valid, it must be informed, understood and voluntary, and the person consenting must have the capacity to make the decision….
However, it also introduces the idea of implied consent, beside written and verbal consent.
An implied consent process [is a process] by which parents are informed of imminent vaccination through social mobilization and communication, sometimes including letters directly addressed to the parents. Subsequently, the physical presence of the child or adolescent, with or without an accompanying parent at the vaccination session, is considered to imply consent….
It has been wrongly suggested that implied consent is being used in UK schools and this has been causing great distress. Implied consent is not used in the UK. In fact the WHO discourages the use of implied consent.
However, there are other issues which parents must be aware of if their children attend school on the day of vaccination. There have been many reports of children being wrongly vaccinated in school with the Fluenz (live influenza) vaccine without parental consent, including hospitalization due to asthma contraindication and one financial award paid out by a private immunization team. Some are due to mistaken identity, some due to misreading the consent form and others due to poor administration (the wrong line of children were taken for vaccines for example.) This situation is made even more difficult if schools do not disclose the date of vaccination day to parents in advance. In secondary schools teenagers can usually consent to vaccinations themselves, assuming the consent is informed and given freely.
*Convention on the Rights of the Child, General Comment No. 4 (CRC/C/GC/4, 1 July 2003) and No. 15 (CRC/C/GC/15, 17 April 2013)