Case 5Anorexia nervosa

Doctor’s Dilemma

• To listen to the “child’s voice”

• To maintain “ family unity”

• To think first and foremost of the child’s best

Legal Area in Children

• GMC guidelines:The children Act 1989

Family Reform Act 1969

Common Law: Gillick vs West Norfolk& Wisbech Area Health

Ethics Principle

• Autonomy- right to make decisions for oneself

• Competence:Understood the following:

proposed therapy

risk of therapy

benefits of therapy

The law

• Mental Capacity Act 2005:

Comprehend and retain information that has been presented

Retain that information

Be able to weigh the information

To communicate his decision( any method even blinking)

Child’s right

• Right to life

• Mercy

• Justice

• Participate in decision- making

Parent’s Right

• Right to make decisions

• Parental authority- widely accepted but not absolute

• Competent adult has the right to refuse the decision made

The Law

• A child is a person under the age of 18 years

• Children aged 16 or 17 can consent to treatment (Family Law Reform Act 1969) if they are competent

• Competence can be based on “Gillick Competent”

Refuse Treatment

• Medical Staff can proceed:

Those who are under 18 years old who has capacity and refuses therapeutic treatment, as long as there is one consenting parent or guardian (even if the other refuses)

ADMISSION

•Voluntary

• Involuntary

•Compulsory