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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

Medical/dental treatment and child's consent

42 replies

FlipnTwist · 21/08/2018 18:25

Before I reveal my hand, please can I ask what you feel the legal and ethical implications are where a child point blank , clearly states they refuse important treatment for serioius but non-lifethreatening ailment.Sorry it's vague but I don't want to influence replies. Age say 11-13

OP posts:
Original poster
FlipnTwist · 21/08/2018 18:26

I am not a journalist- I have been on mn for 17+ years!!

OP posts:
YeTalkShiteHen · 21/08/2018 18:26

If it impacted their quality of life or future health I’d be sketchy about them having the final say.

feathermucker · 21/08/2018 18:27

I'd need to know more context tbh

Sirzy · 21/08/2018 18:28

I think on the whole as long as they can understand the consequences they should be involved

onalongsabbatical · 21/08/2018 18:31

No idea what the legal situation is, but at 11-13 they are developing into adults and I’d be very wary of any coercion if it’s not, as you say, life-threatening. Endless discussion and listening to their point of view with the hope of coming to a good decision in time for the treatment to be effective, but ultimately I’d want to respect their emerging personhood even if they seemed to adamantly want to make the ‘wrong’ decision. Just keep telling them – with as little emotion as possible – what the consequences are/could be. So that their non-consent is as informed as it can be. I assume there’s a long enough time-window given the non-life-threatening aspect.

SilverHairedCat · 21/08/2018 18:31

Need more detail, but as an adult who developed a horrendous phobia of dental treatment around that age and am still, in my late 30s, reaping the rewards of the decades of appalling dental care since then, I strongly suggest you find a way for them to work through it.

pigsDOfly · 21/08/2018 18:33

At that age they are not considered adults as far as medical treatment is concerned and therefore adults have to taken on the responsibility of making those decisions on their behalf.

In every other aspect of their lives the adults in their lives have to make pretty much all their important decisions for them, medical issues are no different.

SassitudeandSparkle · 21/08/2018 18:35

Is it something that can be done later if necessary, or is it better/has a better outcome done at a particular time?

MVLipwig · 21/08/2018 18:37

If it’s something like braces I’d let them decide tbh, with clear explanation that if they change their mind later they get no help paying or sympathy. Particularly if they’re at the higher end of your age range

Bombardier25966 · 21/08/2018 18:37

You need to look at Gillick Competency, and the Fraser Guidelines. They may well reach the required level of competency as a young teen, it will depend on the individual and the treatment in question.

Pengggwn · 21/08/2018 18:40

Well, if the alternative is to hold them down and administer the treatment, I would say the answer is pretty clear: it would be an obscene breach of their physical autonomy and I wouldn't, personally, have anything to do with it.

pigsDOfly · 21/08/2018 18:42

Ah yes, braces on the teeth I would let them decide. Although from your OP I assumed you were talking about more important medical treatment than corrective dental treatment.

Sarahandduck18 · 21/08/2018 18:43

An 11 yo has a legal and moral right to refuse any medical treatment.

pigsDOfly · 21/08/2018 18:44

No holding them down and effectively assaulting them, albeit in the interests of medical treatment, would be completely unreasonable.

SilverHairedCat · 21/08/2018 18:47

Serious but non-life threatening ailment.

Braces on teeth for aesthetic reasons - their choice, allow them to decide and leave it there.

Issues with leg which will lead to permanent back pain and require subsequent hip replacement or knee surgery (for example) - child will be required by me to attend physio / supportive medical appointments and to be educated in why surgical treatment on offer is recommended and what consequences of refusal would be. Would encourage to follow what surgeons said. But would not pin down for the surgery.

Non-wearing of glasses for short sightedness - leave them to it, and offer contact lenses if financially viable or don't if it's not. They'll give in to spectacles if they have to. I did.

Bombardier25966 · 21/08/2018 18:48

An 11 yo has a legal and moral right to refuse any medical treatment.

That depends on the child being competent to make the decision. Some are, some are not.

AdaColeman · 21/08/2018 18:50

If it's braces, I'd discuss it fully with the child but let them have the final decision, because the treatment requires a great deal of cooperation from the subject with possibly years of commitment.
A reluctant subject will be unhappy, the treatment may be slowed, and if abandoned before completion, the result could be worse than if it had not attempted at all.

frogprincess84 · 21/08/2018 18:50

From a dental point of view, at that age if they point blank refused it would be a no can do situation. As others say, the alternative would be to hold them down and that's a total non starter. If it's nerves more than refusal you may be able to get the child referred to a community dentist who can take more time with then or get them some sedation or even a GA if it's for extractions.

guiltynetter · 21/08/2018 18:51

why is everybody saying braces?! the OP hasn’t mentioned what it is, at all.

welshweasel · 21/08/2018 18:53

For a non life threatening treatment you would need to assess Fraser competence. If deemed competent then child can decide.

SilverHairedCat · 21/08/2018 18:59

Legal and ethical implications though....

Gillick and Fraser competence are the main thing.

Are you asking as a parent or a medical professional? The ethics will be set down in the relevant medical profession if that's the case. As a parent, can you look your child in the eye and say you are doing the best thing for them, that you have their trust, that you have not betrayed their trust, that you have not lied to them or tricked them, that you are sure of the decision?

upsideup · 21/08/2018 18:59

If it my childs quality of life would be reduced and that could be completely avoidable with early treatment then I would make the decision for them to have it now.
If the problem wouldnt worsen and treatment could happen when their older if they changed their mind then I would let them decide.

Lisabel · 21/08/2018 19:01

It's tricky isn't it because they might get to 25 and really wish they had the treatment or operation.

I really do not think 11 year olds are capable of making decisions in the same way that adults are; they are less likely to be able to contemplate any long-term consequences because they still very much live in the present.

I would try definitely think the parent should have the final say unless there really are no long-term consequences or unless the child has a very well thought out argument for why they do not need the treatment.

Lisabel · 21/08/2018 19:02

Oops last paragraph was 'I definitely think the parent...'

legolimb · 21/08/2018 19:02

It's impossible to say without knowing all the details.

I had a compliant DS so he would have gone along with it.