Children and young people
Children and young people: principles
Students should be able to demonstrate in practice an understanding of:
- the duty to respect the rights and interests of children and young people
- the legal and ethical aspects of the capacity of young people to consent to and refuse treatment
- the respective roles of parents/guardians, healthcare professionals and the courts in decisions about the treatment of children
- the ethical and legal issues in child protection
- the application of the duty of confidentiality to young people.
Children and young people: teaching and learning
Interactive case studies: waiting room 2, GMC. Consent and children, including: access to children's medical records; if a young person refuses treatment; discussing risks; and assessing capacity.
Medical Ethics Today: the BMA’s handbook of ethics and law, second edition, BMA (2012). See chapter 4, 'Consent and refusal: children and young people'.
Jones, K, 2010: Hannah’s Choice, Harper True. A personal account by Kirsty and Hannah Jones, about Hannah’s illness with leukemia and heart failure and her decisions about heart transplant. Relevant for discussions about Gillick competence.
Films and documentaries
Girl, Interrupted (1999). Based on writer Susanna Kaysen's account of her 18-month stay at a mental hospital in the 1960s. (IMDB.com).
0-18 years: guidance for all doctors, GMC (2007)
Rights and interests of children and young people
Inside the Ethics Committee: Childhood Illness, BBC Radio 4 (2010). When should a seriously ill child have a say in their treatment?
Capacity of young people to consent to and refuse treatment
Wheeler, R, 2006. Gillick or Fraser? A plea for consistency over competence in children BMJ 2006: 332; 807.
Talati, E D, Lang, C W, Ross, L F, 2010. Reactions of pediatricians to refusals of medical treatment for minors J Adolesc. Health. 2010 Aug; 47(2):126-32
Media reports of the case of Hannah Jones who refused heart-lung transplant:
- Right-to-die teenager Hannah Jones changes mind about heart transplant, Guardian (2009)
- Heart refusal girl back at school, BBC News (2010)
- Girl wins right to refuse treatment, BBC News (2008) Hannah's father Andrew Jones giving a statement about how he supported his daughter’s decision.
Roles of parents/guardians, healthcare professionals and the courts in decisions about the treatment of children
Withholding or Withdrawing Life Sustaining Treatment in Children: A Framework for Practice, Royal College of Paediatrics and Child Health (2004)
Critical care decisions in fetal and neonatal medicine: ethical issues, Nuffield Council on Bioethics (2006)
M Brazier, An Intractable Dispute: When Parents and Professionals Disagree, Med Law Rev 2005 13: 412-418
Re C (HIV test)  2 FLR 1004
Re OT (A Child)  EWHC 633 (Fam)
Re D 1986 1 All ER 326
Re B 1987 2 All ER 206
Re Wyatt  EWHC 2247
The end of intolerability: The Charlotte Wyatt case in the Court of Appeal Foster, C UK Clinical Ethics Network Case Commentary 'Wyatt v Portsmouth Hospitals NHS Trust, Commentary on Wyatt v Portsmouth Hospitals NHS Trust  EWCA Civ 1181.
NHS trust v B  EWHC 507 (Fam). Notion of ‘futility’.
Child Protection Companion (PDF file), Royal College of Paediatrics and Child Health (2006)
Child protection - a tool kit for doctors, BMA (2009)
Duty of confidentiality to young people
Confidentiality and disclosure of health information toolkit, BMA (2009). See Card 8: Children and young people.
Best practice guidance for doctors and other health professionals on the provision of advice and treatment to young people under 16 on contraception, sexual and reproductive health, Department of Health (2004)
R (Axon) v Sec State for Health  EWHC 37 (Admin)
'Gillick Rules OK: The Sue Axon Case' Foster C UK Clinical Ethics Network Case Commentary