A 15 year old boy in London is brought to the hospital by his parents complaining of lower abdominal pains for the past three days. A clinical suspicion of appendicitis and the decision to admit was made. The young boy refuses to be admitted as he has plans to go out with his friends tonight. He is unable to understand the serious nature of an untreated appendicitis. His parents would like to overrule his wishes and to admit him. What is the SINGLE most appropriate course of action?
A. Contact the local safeguarding officer
B. Respect his wishes and do not admit
C. Involve social services
D. Refer for a psychiatric evaluation before admission
E. Admit him under parental consent
This young boy is under 16. He lacks maturity and is unable to understand the seriousness of his condition. You therefore can rely on parental consent.
Capacity to consent
The capacity to consent depends more on young people’s ability to understand and weigh up options than on age. When assessing a young person’s capacity to consent, you should bear in mind that:
- At 16 a young person can be presumed to have the capacity to consent - A young person under 16 may have the capacity to consent, depending on their maturity and ability to understand what is involved.
Respect for young people’s views is important in making decisions about their care. If they refuse treatment, particularly treatment that could save their life or prevent serious deterioration in their health, this presents a challenge that you need to consider carefully
Parents cannot override the competent consent of a young person to treatment that you consider is in their best interests. But you can rely on parental consent when a child lacks the capacity to consent. In Scotland parents cannot authorise treatment a competent young person has refused. In England, Wales and Northern Ireland, the law on parents overriding young people’s competent refusal is complex. You should seek legal advice if you think treatment is in the best interests of a competent young person who refuses.
Note that the ability to consent changes if you are under 13. By law children under 13 are considered unable to consent.