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Feminism: Sex and gender discussions

GDPR & Children's medical records

30 replies

Imnobody4 · 18/05/2018 18:40

Hi - am new after lurking for ages. Just received e mail from Voice for Justice about letters recently received giving 13 yr olds authority on parents accessing medical records.

'Letters have recently, and unexpectedly, been falling onto the doormats of what appear at the moment to be selected households – first, a letter to parents, and, second, a letter to children between the ages of 13 and 16. Though differently worded both inform the recipient that after May 25th the legal age for consent to the sharing of information, here defined as medical information,will be 13. Which means that parents, without their child’s permission, would no longer be allowed access to their child’s medical records, including information about current and proposed medical procedures.And children over the age of 13 would be guaranteed complete secrecy, unless they gave permission for their parents to be informed.To put it bluntly, all medical information relating to children over the age of 13 would after May 25th be automatically withheld from parents, unless the child had given his or her explicit consent.'

It means for e.g. child could be prescribed puberty blockers without parent knowing!

OP posts:
Chembe · 18/05/2018 18:44

I was under the impression this was already the case? Or this just in Scotland?

ShovingLeopard · 18/05/2018 18:46

Seems odd, given they are not legally adults and unable to legally consent in other ways. I can see lots of problems with this, including potential issues around hormone blockers. There is a good reason we don't let 13 year olds have sex, marry, vote, go to war etc. They likewise will not always have the capacity to make big medical decisions on their own. Very odd.

changeypants · 18/05/2018 20:58

think this is already the case and has been for a while
en.wikipedia.org/wiki/Gillick_competence

ChattyLion · 18/05/2018 21:31

I agree this seems worrying. Gillick competence is different though because it’s an individual assessment by a doctor of that particular child’s capacity to understand the risks and benefits of a particular proposed treatment at that time. There isn’t a blanket age under 16 from which there is always a presumption of capacity to consent to treatment. 16 and over is always the age of presumed adult capacity to consent, which is then rebuttable.

Thanks have also heard that for data consent only (not medical treatment) there is a blanket age of 13 for everyone, (without any individualised assessment by a doctor) of a presumption of the young person’s capacity to consent around data use. So under GRPR, 13 will be the age of data consent for the child’s data to be used by ‘information society services’ or suchlike (I think this means social media companies) etc. But I think if 13 were correct in relation to health records privacy kicking in, it would be pretty far reaching and and we would have heard a lot more about it surely?? It couldnt make sense for parents to be consenting for a child’s medical treatment (while they are under 16 years old) then the child turned 13 and stopped the parents having access to their health data. So I don’t think this can be correct. Hopefully a GDPR expert will be along soon.

Polynerd · 18/05/2018 21:37

Totally confused by this - my teenage daughter cannot even get the optician to tighten a loose glasses leg without me being there (literally!) so how the heck would they be withholding her eye test results?

Imnobody4 · 18/05/2018 23:42

Something seems wrong but this is part of letter to the child.

XXXX Medical Centre

Consent to Access and Consult for Children aged 13 to 16
regarding Medical Records

Consent for Children aged 13-16 / Last Updated April 2018

What would it mean if I take full control of my health?
Your parents/guardian will not have any access to your personal records, which
means they will not be able to have ‘Access to View’ your records. Also, you will be
required to:
ï‚· Order, collect and amend your own prescriptions.
ï‚· Have all your consultation visits here at XXXX without your mum, dad or
guardian present and speak for yourself.
 You’ll need to speak for yourself during any consultation or communications
and make your own independent decisions regarding your medical needs and
care.
 You’ll need to book, amend cancel your own appointments.
All your medical care and needs would be your responsibility and you would need to
be able to discuss your medical needs with any doctor, nurse receptionist or
administrator here at XXXX without the help of your parent /guardian. This will
include making decisions regarding your health.
If you have any further questions regarding consent, please call XXXX on: XXXXXXXXX, where a member of our team would be able to explain
consent to you and answer any questions you may have.

OP posts:
OlennasWimple · 18/05/2018 23:46

This is horrific. The only 13 yo I can think of who would want to do this are the very vulnerable ones who absolutely need the support and care of their parents or guardians

Ereshkigal · 18/05/2018 23:55

I know 13 is the age where consent has to be obtained from a child to process their data under GDPR but I didn't know that would transcend parental rights.

Ereshkigal · 18/05/2018 23:55

Sounds really worrying.

MirrorMirror21 · 19/05/2018 00:22

I work at a doctors and we have needed 13yo's permission to share medical info/ test results etc with their parents for as long as I've worked there (granted only a year).

womanformallyknownaswoman · 19/05/2018 12:27

I received this email the other day from Voice for Justice UK - I have posted it in full - it is very concerning:

Letters have recently, and unexpectedly, been falling onto the doormats of what appear at the moment to be selected households – first, a letter to parents, and, second, a letter to children between the ages of 13 and 16. Though differently worded (www.gpwebsolutions-host.co.uk/433/files/2018/05/Consent-for-Children-aged-13-to-16-1.pdf), both inform the recipient that after May 25th the legal age for consent to the sharing of information, here defined as medical information, will be 13. Which means that parents, without their child’s permission, would no longer be allowed access to their child’s medical records, including information about current and proposed medical procedures. And children over the age of 13 would be guaranteed complete secrecy, unless they gave permission for their parents to be informed. To put it bluntly, all medical information relating to children over the age of 13 would after May 25th be automatically withheld from parents, unless the child had given his or her explicit consent.

Thankfully at present this move seems limited to only a couple of medical practices, both located in the London area – and VfJUK has so far been unable to find any legal basis for what seems to be a bizarre extension of GDPR, resulting in the removal of parents’ rights. The legal justification seems to be that under the European Union General Data Protection Regulation (GDPR), coming into force in the UK on May 25 (eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex%3A32016R0679), children are able to give lawful consent to the processing of personal data from the age of 16. But – and it’s a big but – EU member states are allowed, if they wish, to lower that age to 13. Under the Data Protection Bill currently going through Parliament, the UK has apparently chosen to do this in relation to the processing of personal data, allowing children from the age of 13 to have the right of sole control (See: www.dpnetwork.org.uk/new-uk-data-protection-bill-factsheet/).

However, the inclusion of medical records and removal of parental rights seem an unwarranted extension of the GDPR, and can only cause concern. For example, should this interpretation be implemented, it would surely mean that, contrary to NHS guidelines regarding treatment for gender dysphoria, recommending that invasive treatment not be given under the age of 18 (www.nhs.uk/conditions/gender-dysphoria/treatment/), teenagers as young as 13 would be able to request and obtain life-changing hormonal and surgical intervention without their parents’ knowledge or consent – indeed, in opposition to their parents’ wishes. Similarly, it would give anonymity to underage girls seeking contraceptive advice or abortion, while both sexes would be able to receive treatment for potentially life-threatening STDs (which of course, should they need it, is good) but without their parents’ knowledge and support.

Far from enshrining a child’s right to privacy and choice, this policy, if rolled out across the country, could have devastating effects. What happens, for instance, when a post-abortion 14 year old haemorrhages and is rushed to hospital, and the parents can’t tell the over-worked doctor in A&E that she’s had an abortion – because they don’t know – so that she receives the wrong treatment? Or what happens to the child who develops clinical depression as result of inappropriate contraceptive advice, but tries to shoulder the burden alone, because she’s too ashamed to tell her parents why? Or the child who suffers a prolapse as result of anal intercourse? Or even the young person who at 13 decides they want sex change surgery – only to decide a couple of years later (as happens) that they made the wrong choice? In effect, such a policy could only act to remove the inhibitions that currently act as safeguards. It would remove protection from children far too young to make life-changing decisions for themselves, in the process playing into the hands of sex abusers by removing the firewall – however inadequate in practice it may be – of parental protection.

However, far from being Government policy, on current information this would appear to be over-enthusiastic misapplication of GDPR – so, VfJUK asks, why? Surely, far from promoting child welfare, this can only further the ideologically driven agenda of sexual libertarianism? After all, the idea that a seriously ill 13 year old might choose not to tell their parents and take sole responsibility for their treatment is ludicrous. Pretty well all of us, when faced by illness, crave the support of our loved ones, so are we seriously to believe that a child, faced, for example, by kidney failure or the need for corrective heart surgery, might not want their parents involved? No, as said, the only possible object of such a policy would seem to be reinforcement and extension of a child’s opportunities in respect of sexual behaviour and gender transition.

Children can only be exposed to risk and left vulnerable by the relentless pressure to take ‘adult’ decisions for which they are simply too young. Parents have not just the right, but the duty, to protect their children – and for this they need to know what’s going on in their children’s lives. Thirteen is too young to bear such responsibility!

So let us reject manipulation of the new regulations to undermine parental rights - that, at the end of the day, serve only as justification for adult proclivities formerly labelled as immoral. If you receive one of these letters, then report the senders for abuse and complain to the data protection regulator. And, please, let VfJUK know.

ChattyLion · 19/05/2018 15:09

However, the inclusion of medical records and removal of parental rights seem an unwarranted extension of the GDPR

This sounds about right

Prawnofthepatriarchy · 19/05/2018 15:50

Womanformallyknownaswoman, the Voices for Justice letter is concerning to me but perhaps for different reasons. I'm somewhat concerned the authors don't know that parents haven't had the unfettered right to across their young teen's medical records since the Gillick case back in the 1980s. What's being said isn't news.

The example they offer, of a 14 yo needing emergency help after an abortion? Have they not considered the possible outcomes were that 14 yo from a family where abortion is strictly forbidden or from one where premarital sexual activity - once discovered - might lead to physical violence? There are very good reasons why some young people need confidentiality and that's been recognized for 40 years.

2rebecca · 19/05/2018 15:54

I think that's just putting a definite minimum age on the Gillick competence rule and formalising what GPs and school nurses have been doing for a few years. Most children over 13 would be regarded as Gillick competent. In practice very few children under 16 come without a parent here in Scotland and many continue bringing a parent along until they're in their 20s.

Potplant2 · 19/05/2018 16:18

I’m very glad I had medical confidentiality in my teens. My medical problems weren’t to do with sex, but they were to do with periods and with mental health and sharing my worries about either of these with my parents would have made things worse. Sadly parents can be abusive. In my experience if a teenager doesn’t want their parents to know about a medical issue there’s a reason for that.

As other posters have said, this isn’t new. It goes back to Gillick competence.

womanformallyknownaswoman · 19/05/2018 16:22

I realise that the Voices for Justice email is not who I thought it was and I have unsubscribed - I'll leave the post up for discussion but don't condone them as an organisation - I have no skin in the game so to speak - you may well be in a better position to know than I (my oldest is in late 20s now)

IAmBreakmasterCylinder · 19/05/2018 16:31

It’s true a child can withhold their consent for their parents to have access but a clinician can still override that if they feel it is in the child’s best interests or if they feel the child is not capable of understanding the ramifications of withholding consent.

Plus the BMA and ICO have not given a definitive answer on age of consent in relation to GDPR yet.

It’s a shower of shit expecting medical practices to put GDPR into place without guidance being finalised. Access to children’s records has always been a grey area. Most sensible clinical settings will continue to do what they always have, assess on a case by case basis with all the facts. Not just blindly follow the letter of the (as yet unclear) Law.

Imnobody4 · 19/05/2018 17:56

I agree about the Voices for Justice as an org. I'm just so confused at how we properly protect teenagers. We don't seem to be moving any closer to a universal approach to sex and relationship education. At the same time we have organisations like Mermaids giving advice with the backing of government. The whole grooming gangs thing has really shaken me - the people who should have been responsible for safeguarding failed.
My question really is if a 13 yr old can consent to medical treatments, can declare they are transgender - why shouldn't the age of consent be lowered to 13?

OP posts:
Prawnofthepatriarchy · 19/05/2018 18:42

Do we know whether HCP intend to use Gillick competence to adjudge whether 13 yos can be prescribed puberty blockers without parents knowing? My understanding is that it's generally used for urgent and sensitive things like contraception and abortion, where the parents may have strong views and the child needs help now or may become pregnant/forced to go through with a pregnancy.

Say a 14 yo was seeking sterilisation or mastectomy. No one would argue Gillick was relevant there. I know if I were a HCP I wouldn't want to prescribe puberty blockers to an under 16 who wouldn't let me tell their parents. The potential exposure would make me very wary. But then I think the transing of children is a bit like musical chairs. At some point the music will stop and lots of people will find chairs thin on the ground.

SardineReturns · 19/05/2018 19:06

On the one hand like in example above a child may need to be able to access sexual health services without parent knowing if they have a family who are likely to make their life hell

OTOH what about older "boyfriends" being able to get their v underage "girlfriends" on the pill without the parents being aware etc

How does this pan out in real life? It's not my area.

Certainly I used anon sexual health services when I was 16 (brook advisory), a blanket rule seems to maybe have gaps? In protection I mean.

SardineReturns · 19/05/2018 19:07

15 even

so it's not new

but then , rotherham etc

ChattyLion · 20/05/2018 05:17

This isn’t about consent to medical treatment (Gillick considerations around that will remain and are something separate, there isn’t a blanket age of consent for treatment ) but this is about consent to sharing of personal medical information.
Data sharing in medicine is dealt with in a different area of law and is not under drs control/gatekeeping in the same way.

ChattyLion · 20/05/2018 06:18

I don’t know who Voice for Justice UK are but they seem to be coming from a ‘parents have a right to know about childs medical treatment under a certain age’ position which I wouldnt support. (or at least, I think the current set up that the UK has around the Gillick determination for medical treatment, generally is very good for young people’s health and rights. Young people under 16 in general are protected via the Gillick consideration. It’s really not the tool of sexual libertarians as the Justice email quoted by woman would imply.
VJUK stance sounds maybe a bit like Sue Axon’s in this case: news.bbc.co.uk/1/hi/england/manchester/4636666.stm

But there is a serious point that needs clarification in this, in relation to consent to medical data sharing and in practice there being a belief that the GDPR advocates for a blanket assumption of non-sharing of the child’s medical data with parents (age over 13) unless the child has specifically consented to that data being shared. In practice that won’t work because between 13 -16 in that same individual child’s case, their paremts may be still giving consent to their medical treatment because the child lacks Gillick capacities.

Gillick works highly individually and specifically by a medical professional assessing the child/young person’s ability to consent to that particular treatment at that particular time. As determined by discussion with their doctor who knows their situation in conversation (or over several conversations) with the young person.
Gillick is also about the child’s capacity to consent to that treatment and is not automatically about ^not telling parents what treatment their child is having’ which are separate issues which Gillick critics tend to conflate.

So because separate areas of law treat data sharing and medical treatment separately and differently in relation to consent.. it seems possible there could be a clash. hitherto UK data law hasn’t had any minimum ‘age of consent’ as I understand it but it seems unlikely that GDPR will be bringing in a blanket age of 13 for consent to medical data sharing with parents.

scrumples · 20/05/2018 06:37

This reply has been deleted

Message withdrawn at poster's request.

ChattyLion · 20/05/2018 06:38

That’s what I had assumed too scrumples.