5.10 Consent to Contraception

Question 1

Over 18s are adults, when 16 and 17 yr olds make decisions?

Answer 1

They can make independent decisions about their health but if they refuse this CAN be overruled in certain situation by parents, guardians or court.

Question 2

When under 16s make decisions?

Answer 2

They can make decisions only if shown to have Gillick Competence (and usually not under 13s)

Question 3

What does Gillick Competence mean in a person?

Answer 3

Must be assessed on a decision by decision basis; understanding and intelligence, implication of treatment and voluntarily taken (no coercion).

Question 4

What are specific guidelines for providing contraception to under 16s?

Answer 4

Fraser guidelines for under 16s where there isn’t parental input or parental consent

(House of Lords 1985)

Question 5

What are the Fraser criteria?

Answer 5

1. Mature and intelligent enough to UNDERSTAND the treatment
2. Can’t persuade them to involve parents
3. Likely to have intercourse even without treatment
4. Physical or mental health will suffer without treatment
5. Treatment is in their best interest

If they meet Gillick competence and Fraser guidelines then contraception can be given in confidence from parents.

Question 6

What if the child is not Gillick competent?

Answer 6

If child is risk of harm this should be escalated as a safeguarding concern

Question 7

What are some safeguarding concerns?

Answer 7

Under 13s cannot consent to sexual activity, escalate.

Abuse, exploitation, etc

Confidentiality may need to be broken.