Consent

The generic NHS definitions for consent to treatment are:

• Voluntary consent: The decision to either consent or not to consent to treatment must be made by the person and must not be influenced by pressure from medical staff, friends or family
• Informed consent: The person must be given all the information regarding what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments and what will happen if the procedure or treatment does not go ahead
• Capacity: The person must be capable of giving consent which means they fully understand the information given to them and can use it to make an informed decision
• Proxy: This involves the sharing of a person’s access to health and care services with another person when there is a legitimate need to do so but the person is not able to take responsibility for delegating this themselves. Examples include, a parent claiming access to a child records, and Power of Attorney (PoA)

You can give consent in the following ways:

• Verbally: consenting to an examination or procedure by word of mouth.
• Written: signing a consent form.
• Implied: you may give non-verbal consent as long as you understand what is asked or about to take place.

You can withdraw consent at any time.

The Age of Legal Capacity (Scotland) Act 1991 at Section 2(4) clarifies the legal position on the capacity of children under the age of 16 years to consent to medical treatment. A child aged 12 or more is presumed to be of sufficient age and maturity to form a view, although it is important to remember that this is only a starting point, and each child will be assessed as an individual to determine whether or not they have capacity.

There is a duty to keep the child’s best interests at the heart of any decision and the child or young person should be involved in the decision-making process as far as possible. However, it is deemed good practice to involve the family or carers of the child in the decision-making process providing the child is content for this information to be shared.  

A competent child is legally entitled to withhold consent to treatment. However, if the treating clinician believes that the withholding of consent may be detrimental to the patient’s wellbeing, legal advice may be required. It may be necessary for a court to determine whether treatment can be given against the wishes of the competent young person.

It should be noted that while there is no lower age limit for guidelines to be applied, it would rarely be appropriate or safe for a child who is under 13 years of age to consent to treatment without a parent’s involvement. 

If we do not believe the child is capable of understanding the treatment or procedure and its possible consequences, then the child cannot legally consent and it may be necessary to seek this elsewhere, for example from birth parents or others with parental rights and responsibilities such as foster parents or carers. Parental consent is not necessary when a child is receiving counselling or preventative care. 

Unmarried fathers do not automatically have parental responsibilities. Neither is it necessary to obtain the consent of everyone who has parental responsibilities and rights.

We use the below document to determine Parental Responsibility to ensure the child or young person's rights are protected.