Dr Peter Moore: Why parents can't overrule a child's Covid vaccine wishes
- Credit: PA
It made dramatic headlines.
Even if parents do not want their child vaccinated doctors, can still go ahead if the child agrees?
Is this a new breach of parent’s rights? How can a child know better than the parents?
The idea is neither new nor an attempt to ride rough-shod over the rights of parents.
It originated over an entirely different issue.
In 1985, the Department of Health sent out guideline for doctors on the difficult problem of how to manage a case when a girl under 16 asks for contraception.
The circular argued that it was a matter for the doctor to decide after carefully listening to the patient.
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Doctors, it explained, do not always need the parent’s consent.
Occasionally it may be necessary to prescribe contraception without the parent’s knowledge and parents have no power of veto.
Victoria Gillick, a 39-year-old Roman Catholic mother of 10, ran a campaign against this advice.
A doctor prescribing contraception to an underage girl, she argued, is committing an offence by encouraging sex with a minor.
Doesn’t any medical treatment in underage children need consent from the parents?
She took the matter to court and was unsuccessful in the High Court but won her appeal.
The case then went to the House of Lords.
They were not looking at the legal debate around underage sex only whether a child under 16 could consent to medical treatment without the agreement of the parents.
Although I still hear people talking about the 'rights of parents', this is a myth.
The Law Lords ruled that the only 'parental right' is the right to ensure the best interest of the child.
A parent, they ruled, has no right to determine whether their child should have medical treatment once the child has 'sufficient understanding and intelligence to understand fully what is proposed'.
This is now known as 'Gillick Competence'.
The ruling changed medicine. The doctor now had to assess whether someone under 16 had the understanding and intelligence to understand their medical condition and 'all aspects' of the proposed treatment.
We also needed to try to convince the young person to talk to their parents or find a good reason why this was not possible.
In the case of contraception, the doctor had to be convinced that they will have sex whether or not contraception is prescribed.
It was very important that we made detailed notes to show that we had assessed 'Gillick Competence'.
It also meant that we cannot show a young person’s records to the parents if they are Gillick Competent.
From the point of view of a jobbing GP, I found the guidance very helpful.
In Torbay, we had a large number of teenage pregnancies.
There was also research which showed that when girls ask for contraception most are already having sex, often with no contraception.
What was my legal position if she was under 16?
I was very reluctant to tell her parents but where did I stand legally?
With this ruling, our legal situation was clear.
And now the whole issue has come up again with Covid vaccination.
The same rules apply. If anyone under 16 is Gillick Competent and wants the vaccine the parents cannot stop it.
Of course, it could also work the other way round. If parents are desperate to have their child vaccinated but the child refuses, the doctor must use the same rules, are they competent to make the decision?
The situation will be very rare.
The younger the child, the less likely they are to be Gillick Competent.
Very few 12 year olds could fully understand what is proposed. Any child who thinks that the views of the rapper Nicki Minaj are more informed than the advice of the Chief Medical Officer is unlikely to have 'sufficient understanding and intelligence to understand fully what is proposed'.
These rules are not new. They have been tried and tested for over 35 years and work well.