Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about consent to treatment. And if you want to follow along with written notes on this topic,

you can follow along at zero tofinals.com slash consent or in the development section of the

Zero to Finals Pediatrics book.

So let's get straight into it.

A person is recognized as an adult with full autonomy to make decisions about their health

when they turn 18.

16 and 17-year-olds can also make independent decisions about their health,

but if they refuse treatment, this can

be overruled in certain situations by their parents, people with parental responsibility or the

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

Gillick competence. There is no lower limit to the age where children

can make decisions about their health, however it's unusual for consent to be taken from someone

under 13. The way this is usually tested in exams relates to girls under 16 seeking contraception

from their GP. This is the scenario that established Gillick competence and Fraser guidelines in the first place.

Gillick competence.

Gillick competence refers to a judgment about whether the understanding and intelligence of the child is sufficient to consent to treatment.

Gillic competence needs to be assessed on a decision-by-decision basis intelligence of the child is sufficient to consent to treatment.

Gillick 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 given voluntarily.

When prescribing contraception to children under 16 is important to assess for coercion or pressure, for example coercion by an older partner.

...