A child (anyone under 16 years old) can consent to treatment as long as they have enough understanding and intelligence to appreciate fully what is involved in their treatment. This is known as being ‘Gillick competent’. Additional consent by a person with parental responsibility is not required.
A young person (anyone aged 16-17) is presumed to be capable of consenting to their own medical treatment. Consent will only be valid if it is given voluntarily by a young person who has received and understood the appropriate information. As with adults, a young person has the right to refuse to consent to treatment.
Where a child under the age of 16 lacks the capacity to consent, consent can be given on their behalf by any one person with parental responsibility or by the court (see below).
In cases where a young person or child deemed ‘Gillick comptetent’ refuses to consent to treatment, a court can overrule their decision if this could lead to death or severe permanent injury. The court used is the Court of Protection, which resolves disagreements about what’s in someone’s best interests.
Consent to treatment
It is a legal and ethical principle that a person must give valid consent before they receive any type of medical treatment. Consent is required from a patient regardless of the treatment, from a blood test to major surgery. Read more about Consent to treatment.
For consent to be valid, it must be given voluntarily by an appropriately informed person who has the capacity to consent. Capacity means the ability to use and understand information to make a decision. The Mental Capacity Act defines a person who lacks capacity and how an assessment is made. Read more about capacity to consent to treatment.
Children lacking capacity to consent to treatment
If a child under 16 doesn’t have the capacity to consent to treatment, someone with parental responsibility can consent for them. The person with parental responsibility must have the capacity to give consent, be acting voluntarily and be appropriately informed. The child’s welfare or ‘best interests’ must be the first concern.
If a parent refuses to give consent for a particular treatment, the courts can overrule this decision if they think treatment is in the child’s best interests.
If one person with parental responsibility gives consent and another doesn’t, the healthcare professionals can accept the consent and perform the treatment. If the people with parental responsibility disagree about the child’s best interests, the courts can decide.
In an emergency, where treatment is vital and waiting for parental consent would place the child at risk, treatment can proceed without consent.
The following people can have parental responsibility for a child under 16:
- the child’s mother
- the child’s father if he was married to the mother when the child was born
- for children born before December 1 2003 – the child’s father, if he marries the mother, obtains a parental responsibility order from the court or registers a parental responsibility agreement with the court
- for children born on or after December 1 2003 – the child’s father, if he registered the child’s birth with the mother at the time of the birth, or if he re-registers the birth (if he is the natural father), marries the mother, obtains a parental responsibility order from the court or registers a parental responsibility agreement with the court
- the child’s legally appointed guardian
- a person with a residence order concerning the child
- a local authority that is designated to care for the child
- a local authority or person with an emergency protection order for the child
Read the answers to more questions about NHS services and treatments.