If you’re interested, there was a case where a 20-year old was pregnant when she was injured in a car accident (4-). She desperately needed a blood transfusion, but had been brought up as a Jehovah’s Witness (they don’t believe in blood transfusions). She refused blood transfusions twice but the doctors basically gave them to her anyway because of the “undue influence” of her mother who was proper hardcore Jehovah’s Witness and was effectively poisoning her daughter’s mind. There’s a bit more to the story but it’s not necessary – the point is that the patient must not be subject to undue influence when consenting to (or refusing) treatment.
Importantly, a person’s decision does NOT have to be considered reasonable for them to be considered competent to make it. Patient C (paranoid schizophrenic at Broadmoor) suffered an injury that caused his foot to become gangrenous and require amputation, without which there was an 85% chance he would die. As he understood that the doctors thought he was going to die and weighed this information to come to the decision himself that they were wrong and he did not want the operation, he had the capacity to decide not to consent and so the doctors were not allowed to perform the amputation (again, sorry about the mouthful). His mental health issues did not render him automatically incompetent and his autonomy was upheld (5-).
Lawful treatment can be given without consent in circumstances of necessity where emergency intervention is required to prevent grave injury/ death and the patient is not in a position to consent (passed out). Under the Mental Health Act, patients may be given compulsory treatment and admission for assessment, but only for the mental disorder in question.
A child is considered to be anyone under the age of 18 and in accordance with the Children Act (1989) anybody with parental responsibility on behalf of the child can give consent so long as the decision safeguards/promotes the welfare of the child.
The Family Reform Act 1969 allows children aged 16 or 17 to consent to treatment and have increasing levels of autonomy. However, the child will have to display Gillick Competence (6-), named after the first case in which a competent child was acknowledged- Mrs. Gillick challenged the legality of doctors providing contraceptive advice and treatment to children under the age of 16 without parental consent so long as the child is able to show that they are intelligent enough to understand fully what it is they are consenting to.
If a child and parent disagree, then the child’s rights to autonomy are increasingly valued the older they are, and if necessary the courts can intervene and their decision is upheld above either the parents or the child. Certain procedures require court approval regardless of who wants it – non-therapeutic sterilisations, refusal of life-saving treatment, abortion and donation of non-regenerative tissue.
How to answer a question about consent