Gillick competence
Gillick competence is a legal term originating in England and is used to determine whether a child (under the age of 16) can consent to their own medical treatment, without the need for parental permission or knowledge. The term derives from a landmark case in 1985, Gillick v West Norfolk and Wisbech Area Health Authority, where Mrs. Victoria Gillick contested the lawfulness of doctors giving contraceptive advice or treatment to under-16-year-olds without parental consent. The Supreme Court's decision has since had a profound impact on medical law and the rights of minors in the UK and has influenced discussions on children's capacity and rights in other jurisdictions.
Background
The concept of Gillick competence centers around the idea that children can be deemed competent to give valid consent to medical procedures if they have sufficient understanding and intelligence to fully comprehend what is proposed. This is a departure from the previously held notion that parental consent was always required for minors. The Gillick case set a precedent that a child's ability to consent depends on their maturity and not merely their age.
Legal Framework
In the Gillick decision, the court established that for a minor to be deemed Gillick competent, they must be able to understand the nature, purpose, and possible consequences of the treatment. This includes an understanding of the potential benefits and risks involved. The assessment of Gillick competence is therefore not based on a fixed age but on the child's individual ability to understand the treatment in question.
Application in Medical Practice
In practice, healthcare professionals must assess a child's competence on a case-by-case basis. This involves discussions with the child to evaluate their understanding of the treatment, including its implications and any alternatives. If a child is found to be Gillick competent, they can consent to their treatment independently. However, it is generally considered good practice for healthcare professionals to encourage the child to involve their parents in the decision-making process, unless doing so would not be in the child's best interest.
Implications and Criticisms
The concept of Gillick competence has been influential in promoting the autonomy and rights of minors. It acknowledges that children, particularly as they approach adolescence, can have the capacity to make informed decisions about their health care. However, the application of Gillick competence has also faced criticism. Some argue that it places too much responsibility on children and healthcare professionals, potentially leading to decisions that may not be in the child's best interest. Others contend that it undermines parental rights and responsibilities.
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