Obtaining consent from minors with parental responsibility

Abstract

Britain has the highest rate of pregnancies in Europe among young women aged 15–19 years. In girls under 16, the rates of pregnancy are rising: in 2006, there were 7.8 conceptions per 1000 girls; in 2007, there were 8.3 conceptions per 1000 girls. Where babies are born with conditions requiring treatment, the clinician may be faced with the task of obtaining consent from a parent who is also a minor. These situations present potential pitfalls. Guidance from legislative acts and case law is sparse. For example, the Children Act 1989 does not specify age limits for the assumption of parental responsibility. Legal precedents for assessing competence and capacity may not apply to minors. The Gillick principle for assessing competence does not extend to the competence of minors to take decisions as responsible parents. The Mental Capacity Act 2005 prescribes the limits of capacity but only in those aged over 16 years. Lastly, although a minor's parents will bear responsibility for the minor, this responsibility does not extend to the minor's child. This article explores these controversies through four case scenarios. These scenarios are loosely based on the authors' prior experiences as paediatric surgeons. In light of current statutory guidance, and the paucity of legal precedent, there are few answers to be offered. However, exploring the issues, enabling them to be thoughtfully considered by health professionals, is in itself valuable.