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Report No. 196

Lord Donaldson then laid down six principles, which read as follows:

(1) No doctor can be required to treat a child, whether by the Court in the exercise of its wardship jurisdiction, by the parents, by the child or anyone else. The decision whether to treat (a patient) is dependent upon an exercise of his own profession judgment, subject only to the threshold requirement that, save in exceptional cases usually of emergency, he had the consent of someone who has authority to give that consent. In forming that judgment, the views and wishes of the child are a factor whose importance increases with the increase in child's intelligence and undertaking.

(2) There can be concurrent powers to consent. If more than one body or person has power to consent, only a failure to or refusal of consent by all having that power will create a veto.

(3) A 'Gillick Competent' child or one over the age of 16 will have power to consent but this will be concurrent with that of a parent or guardian.

(4) 'Gillick Competence' is a development concept and will not be lost or acquired on a day-to-day or week-to-week basis. In the case of mental disability, that disability must also be taken into account, particularly where it is fluctuating in its effect.

(5) The Court in the exercise of its wardship or statutory jurisdiction has power to override the decisions of a 'Gillick Competent' child as much as those of parents or guardians.

(6) Waite J, was right to hold that R was not 'Gillick Competent' and, even if R had been (the Judge), was right to consent to her undergoing treatment which might involve compulsory modification."

Medical Treatment to Terminally Ill Patients (Protection of Patients and Medical Practitioners) Back

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