Hi, this is Tom, and in this episode I'm going to be going through consent to treatment in children.

And you can find notes at zero to finals.com slash consent and in the zero to finals pediatrics book.

And you can find flashcards and questions to train your knowledge

at members.toretofinals.com. So let's jump straight in. A person aged 18 or over is recognized as an adult

with full autonomy to make decisions about their health. Those aged 16 and 17 years can also make

independent decisions about their health. However, if someone aged 16 or 17 refuses treatment,

in certain circumstances the court can override this decision, although in reality this is rare.

Children under 16 can make treatment decisions, but only if they're deemed to have

Gillick competence. There is no lower age limit for when children can make decisions about

their health, although it's unusual to obtain

consent from somebody under 13. Refusal of treatment can be overridden to prevent significant

harm. The way this is often tested in exams relates to girls under 16 years seeking contraception from their GP.

This is the scenario that originally established Gillick Competence and the Fraser Guidelines.

Let's talk in more detail about Gillick competence.

Gillick competence refers to a judgment about whether a child's understanding and

intelligence are sufficient to consent to treatment.

Gillic competence needs to be assessed on a decision-by-decision basis, checking

whether the child understands the implications of the treatment.

Consent needs to be obtained voluntarily.

When prescribing contraception to children under 16, it's important to assess for coercion or pressure,

for example coercion by an older partner.

This might raise safeguarding concerns.

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