Consent triage

You must always reflect when you are dealing with:

• A child or young person (under 16) with limited capacities to consent
• A competent adult (adult is assumed competent unless shown to lack capacity
• An adult (16+) with limited or no capacities to consent

Age capacity to consent

• All people aged 16+ are presumed by law to have the capacity to consent according to the Age of Legal Capacity Act
• However, also according to the Age of Legal Capacity Act people under 16 have legal capacity to procedures/treatment where, in the opinion of a qualified medical practitioner attending him, he is capable of understanding the nature and possible consequences of the procedure/treatment
• When obtaining consent, the doctor must establish whether the child is legally competent ('have capacity') to give consent
• In cases of real emergency you can treat people without their consent if the treatment is necessary to save someone's life or prevent serious deterioration

Assessment of capacity

If unsure, it is your duty to assure the patient can:

• Understand the treatment options and weigh up potential benefits, risks, burdens, and side effects of the options
• Retain the information provided
• Weigh up, decide, and communicate their decision
• Make a decision free from pressure

Basic rules of treatment where child is competent to consent

• In Scotland parents cannot authorise treatment a competent young person has refused
• If treatment is in the best interests of a competent young person who refuses, seek legal advice
• Weigh up the harm to the rights of children and young people of overriding their refusal against the benefits of treatment