Is age the best indicator of whether somebody is mature enough to be able to make informed decisions about, for example, medical and clinical interventions?
If a 15-year-old myope wants to wear contact lenses for rugby and attends the practice without a parent or guardian, most of my trainees (English-based) suggest that if the child is Gillick competent, then going ahead with the fit is fine. None have suggested contacting the parent first even if consent should be forthcoming, which would be my first approach. I would certainly consider Gillick if consent was not likely (the parent does not want their child to have lenses due to their own previous experiences) and, as in this case, there was good reason for contact lens correction.
The Gillick case decided that medical treatment could be consented to by someone under 16 without parental knowledge or required consent if, as stated by Lord Scarman, ‘the child achieves sufficient understanding and intelligence to understand fully what is proposed.’ Similar provision is made in Scotland by the Age of Legal Capacity (Scotland) Act 1991.
At a local level there are some exceptions implemented, such as the need for parental consent for the treatment of children with asthma using standby salbutamol inhalers in schools. These restrictions have yet to be tested in court.
The Gillick decision was, in my view, a very sensible one as age is a poor predictor of intellectual maturity. If, however, I was to make a judgement, I would clearly record the justification for going ahead (contact lenses for my example seem a sensible option) and also why parental consent was not being sought (in this case because of probable refusal based on prior experience likely to bias the decision against successful outcome). I’d feel more comfortable then if it was me unfortunate enough to be the one tested in court.
