Executive summary

This piece examines the respective rights of parents and children to consent to matters relating to children’s healthcare. The issue received recent high profile national and international media attention when the case of Charlie Gard, a child suffering from a rare disease, came before the Courts when his parents disagreed with the treating clinicians’ proposed treatment plan. Defining the nature of, and the limits of parental authority in such matters, and addressing when the state should intervene in the child’s interests proved to be divisive and controversial. There were strongly held views publicly posited for the parental right to decide, and equally strong views advocating state intervention to act in Charlie’s best interests.

It shall be submitted that autonomy, or informed consent as it appears in the medico-legal concept, is a vital concept demonstrating our respect for persons. It is fundamentally valuable to promote well-being, and the encouragement of children and young people to exercise self-determining decision-making facilitates their social and legal education and development, and advances their healthy mental functioning.

The position at common law was somewhat unclear as to when a child could give a valid legal consent to medical treatment, but the common law had never viewed the consent of a child as having no legal force whatsoever. Parliament relieved some of the uncertainty when it clothed the sixteen and seventeen-year old patient with the right to consent to, (and, it was thought, by correlation to refuse) medical treatment by virtue of the Family Law Reform Act 1969. The House of Lords extended this respect for the autonomous decisions of young people to those aged under sixteen, provided they had reached the requisite level of understanding, in the case of Gillick. Parental rights terminated when the minor reached this level of understanding, and the seminal decision was said to herald a new-found respect for the rights of young people and a cessation of parental authority.
Regrettably, a judicial retreat followed the decision in Gillick, and the mature minor was once again placed in a position of legal uncertainty when the case was subsequently interpreted by the Court of Appeal as having awarded the competent minor with a perverse sort of right – a right to consent to treatment, but not a right to refuse it. Further, the right of the minor was coterminous with the rights of the parents to make the decision, and so treatment could be lawfully administered notwithstanding the refusal of the competent minor.
Parents have the right to decide for their children who lack the capacity to decide for themselves, and these rights stem from their parental duties to promote the welfare of their minor children. Where parents and clinicians disagree, then it falls to the Court to decide how the child shall be treated, and the Court is guided by what is in the child’s best interests. There have been instances where the Courts have placed
undue weight on the views of the parents when they oppose treatment, when the clinical evidence points strongly in favour of treatment going ahead. It shall be submitted that the Courts have not achieved the correct balance between protecting minors and the rights of their parents because the competent minor has been rendered uncertain of her rights, whilst her parents and the Courts have maintained a paternalistic authority over her personal bodily integrity. The minor who is not able to decide for herself has not always been treated as a person having rights of her own and, indeed, her rights have erroneously been deemed to be as one with that of her parents. Introduction
Before a doctor may legally provide medical treatment to her patient, she must obtain a lawful consent.1Treating a patient without lawful consent would amount to a criminal battery against the patient, and proceeding to treat with consent which is defective in law would lead to her potentially incurring tortious liability in negligence.2Adult patients hold the legal right to decide whether or not to undergo medical treatment and may decide ‘for religious reasons, other reasons, for rational or irrational reasons or for no reasons at all, choose not to have medical intervention…even though the consequences may be her own death.’3If the adult patient is affected by an ‘impairment of, or a disturbance in the functioning of, the mind or brain’4which impedes her ability to reach an informed decision regarding her health-care, then the doctor should treat the patient in line with her best interests.5
The child patient does not enjoy the correlative legal right to decision-making autonomy in the health-care context. The seminal case of Gillick6involved a detailed examination of the respective rights of parents and children to make decisions relating to health-care of those under 18 years of age. It was thought to have hailed an evolution of the legal status of children as a moral agent with capacity to make self-determinative decisions regarding their own treatment in some circumstances and, as a result, the ‘legal position of children (was) immensely strengthened vis a vis any person holding parental rights with respect to them.’7
However, subsequent successive decisions by the Courts have reverted to a more paternalistic approach to treatment decisions relating to children and there has been an erosion of the respect which had been accorded to young people by the House of Lords in Gillick.

 

In what follows, the rights of parents and children to decide on the
1 Chatterton v Gerson [1981] QB 432. 2 Lesley Johnston, ‘Informed consent and the lingering shadow of Chester v Afshar: Part 1’ (2015) SLT 81 at p82. 3 Re MB (An Adult: Medical Treatment) [1997] 2 FLR 426. 4 Mental Capacity Act 2005, s2(1). 5 Ibid s1(5). 6 Gillick v West Norfolk and Wisbech AHA [1985] 3 All ER 402. 7 John Eekelaar, ‘The eclipse of parental rights’ (1986) LQR 4 at p7.
medical treatment of children shall be examined at common law. A discussion of the applicable statutory provisions will then be conducted, and the decision in Gillick shall be detailed. Subsequent case-law shall be examined and finally, it shall be submitted that the Courts have failed to strike the appropriate balance between so-called parental rights and the protection of minors and the law has become unnecessarily convoluted, and children have been left uncertain of their rights in the medico-legal sphere.

Autonomy
Autos, meaning self, and nomos, meaning rule or law as applied to an individual, is interpreted as meaning that the individual’s actions and decisions are their own, and not those of another, outside authority.8 The legal requirement of obtaining lawful consent in the health-care context has been said to be the legal affirmation and recognition of the autonomy of the patient.9 Patients are to be accorded a choice as to what happens to their bodies, and autonomy is seen as a vital doctrine in ethical theory in that it signifies our respect for persons.

If doctors are clothed with the authority to treat their patients without their consent, this would amount to a failure to respect the individual, a failure to recognise their right to decide what happens to their own bodies amounts to a ‘denial…that is particularly damaging…(since)…one’s body is irreplaceable and…because my body is me, failure to respect my wishes concerning my body is a particularly insulting denial.’11 Encouraging children and young people to exercise their autonomy is a vital part of their social education, and greatly promotes healthy psychological functioning into adulthood.12 Parents and children’s rights at common law
Generally, those aged below 18 years of age are legally considered to be children although there are separate, inconsistent age limits which the law imposes on those not yet considered adults. Ten-year olds can be deemed criminally responsible in certain circumstances, sixteen-year olds may marry but may not drive a car until they are seventeen, or vote in an election until they are eighteen.13Historically, there was longstanding ‘uncertainty in medical circles about the capacity of minors to consent to medical procedures.’14It was commonly thought that prior to the decision in Gillick, those under eighteen were always considered incapable of consenting to medical
8 Ronald Dworkin The theory and practice of autonomy (CUP 1988) at p13. 9 Tom Beauchamp & James Childress Principles of biomedical ethics (5th edn OUP 2001) at p64. 10 Dworkin (n8) at p30. 11 Ibid at p113. 12 Lois Weithorn ‘Involving children in decisions affecting their own welfare’ in Melton, Koocher & Saks (eds) Children’s competence to consent (1983 Springer) at p257. 13 Emily Jackson Medical law, text, cases and materials (2nd edn OUP 2010) at p254. 14 Peter Skegg Law, ethics and medicine (2nd edn Clarendon Paperbacks 1988) at p49.
treatment and that parents were the only parties clothed with the authority to provide a lawful consent, but this belief was based on a misunderstanding of the reality.15
If the law had always treated those aged under eighteen years as lacking the ability to provide a lawful consent, it would lead to bizarre results. ‘Touchings’ in a clinical context are the same, in law, to other ‘touchings,’ and so a seventeen-year old would be unable to consent to a haircut, and hugging a grandchild without the consent of her parent would render the grandparent guilty of a battery.16In the criminal case of R v Donovan17 which concerned the alleged indecent assault of a seventeen-year old girl, the issue of whether she was able to lawfully consent to the touchings did not arise, because it was simply taken for granted by the Court that she could have given a lawful consent despite the fact that she had not attained majority.
The common misconception that those aged below sixteen could not provide a lawful consent seems to be linked to the popular belief that only those aged over sixteen could lawfully consent to sexual relations. This belief is also mistaken because ‘this aspect of the law supports the view that persons under sixteen are sometimes capable of consenting.’18In the criminal case of R v Howard19the accused was acquitted of rape on the basis that the girl who was aged below sixteen had consented to intercourse and the Court held, ‘There are many girls under sixteen who know full well what it is all about and can properly consent.’20In such cases, the ‘child’ under sixteen is capable of giving a lawful consent, and the accused would only be guilty of the offence of unlawful sexual intercourse21and he would not be guilty of the much more serious crime of rape.
In Hewer v Bryant22the issue arose as to whether a fifteen-year old boy who worked and lived away from his parents could be said to be within their custody. Lord Denning rejected ‘the notion that an infant is, by law, in the custody of his father until he is 21.’23 Such ideas were old fashioned and unrealistic and the ‘legal right of a parent to the custody of a child ends at the 18th birthday: and even up until then, it is a dwindling right which the courts will hesitate to enforce against the wishes of the child.’24
By analogy, the reasoning in these cases explicitly acknowledging the ability of younger people to exercise their autonomous decision-making capacities would equally apply in the health-care context, and contrary to the prevailing view of the position prior to Gillick, ‘the common law had never regarded the consent of a child
15 Ibid at p51. 16 Patrick Devlin Samples of lawmaking (OUP 1962) at p84. 17 [1934] 2 KB 498. 18 Skegg (n14) at p52. 19 [1966] 1 WLR 13. 20 Ibid at [15]. 21 Sexual Offences Act 2003, s9. 22 [1970] 1 QB 357. 23 Ibid at [369]. 24 Ibid at [376].
as a complete nullity.’25An assessment would be undertaken as to whether the child could comprehend what the particular treatment involved and if he had the capacity to appreciate the nature of and the consequences of the treatment in question, he had the lawful authority to consent under the common law. Family Law Reform Act 1969, s8
Parliament provided some clarity regarding the ability of the older child to validly consent to health-care treatment by enacting the Family Law Reform Act 1969. The statute confirmed that young people who reached sixteen years of age were as capable as adults of giving a lawful consent to medical treatment, and it would no longer be necessary for the health-care professional to seek parental agreement prior to treating the patient lawfully.

There was now, therefore, a presumption that the sixteen and seventeen-year old patient had the requisite capacity to consent to treatment. This presumption could be rebutted if the young person did not have the cognitive capacity to reach an informed decision.27Parliament’s empowerment of the more mature minor was a response to concerns that many young people aged over sixteen were living independently of their parents, and some were married parents themselves28,and it would be wholly unrealistic and impractical to impose a duty on doctors to seek parental consent in such cases. Parental rights must yield to modern realities and health-care professionals and sixteen and seventeen-year old patients were rendered more certain of the legal framework. The statute explicitly maintained the pre-existent common law and thus, for the patient below sixteen years of age, there was ‘still the possibility of consent being given on the basis of the minors’ common law capacity.’29 Gillick The Department of Health published family planning guidance which was issued to Health Authorities in 1980. Controversially, the publication stated that in exceptional situations, health-care professionals could lawfully provide family planning advice and contraceptive treatment to minors below sixteen years of age without parental consent. Mrs Gillick challenged the lawfulness of this guidance, asserting a young person aged below sixteen could not lawfully consent to contraceptive treatment, that her rights as a parent would be violated if her daughters were so treated, and it would be a criminal offence on the part of any doctor to provide such treatment.
The House of Lords held that contraceptive treatment could lawfully be given to a patient below the age of sixteen without parental consent and the minor could, in law, consent to such treatment on her own behalf. The express preservation of the pre-existent common law rules relating to minors by s8(3) Family Law Reform Act
25 Margaret Brazier & Emma Cave, Medicine, patients and the law (6th edn MUP 2016) 463. 26 Family Law Reform Act 1969, s8. 27 Re T (adult: refusal of treatment) [1992] 4 All ER 649. 28 Brazier & Cave (n25) at p460. 29 Skegg (n14) at p51.
1969 meant that the question of the lawfulness of the consent of a child had been left open.30It would be ‘absurd to suggest that a boy or girl aged 15 could not effectively consent…(if they are)…capable of understanding what is proposed, and of expressing his or her own wishes.’31The decision was viewed as hailing a new era of judicial approval and acknowledgment of children’s rights,32and on the issue of parental rights, Lord Scarman unambiguously affirmed ‘that as a matter of law the parental right to determine whether or not their minor below the age of 18 will have medical treatment terminates if and when the child achieves a sufficient understanding and intelligence to enable him or her to understand fully what is proposed.’33The views of the parent cease to be legally relevant when the child attains what became known as Gillick-competence, because parental rights are extinguished at this point.34The rights of parents exist only in so far as they benefit the minor child and ‘parental rights derived from parental duties’.

The decision in Gillick was ground breaking, signalling the end of the absolutist authority of parents and the significance of the decision in terms of the balance of the rights of children and their parents could not be stated too strongly.36
It was thought that the self determination of a competent minor could not now be undermined,37because the House of Lords had adopted a rights-based approach to the issue of self-determination in the health-care context and the decision marked a transfer of decisional autonomy from parent to child providing she attained Gillick competence. As the jurisdiction of the Court to make health-care decisions for children originated from the Crown’s duty as parens patriae, it was thought that the Court would no longer be empowered to overrule a competent child either.38 The reversion to paternalism
The case of Re R39 concerned a fifteen-year old girl who was within the care of the local authority after suffering deteriorating mental health problems. She was violent, paranoid and suffered hallucinations which caused her to be suicidal. R was placed into an adolescent psychiatric unit, where the health-care team wanted to administer medication to her but she did not consent to the administration of the proposed anti-psychotic medication. R’s mental state had ameliorated to the point where she was not ‘sectionable’ under the Mental Health Act 1983, but it was thought that if treatment did not continue, her health would deteriorate to the point that she would
30 Gillick (n6) at [167]. 31 Ibid at [169]. 32 Margaret Brazier & Caroline Bridge ‘Coercion or caring: analysing adolescent autonomy’ (1996) 16 LS 84 at p84. 33 Gillick (n6) at [188-189]. 34 Jackson (n13) at p265. 35 Brazier & Cave (n25) at p463. 36 John Eekelaar ‘The emergence of children’s rights’ (1986) 6 OJLS 161 at p181. 37 Ian Kennedy & Andrew Grubb Medical Law (3rd edn Butterworths 2000) at p596. 38 Eekelaar (n36) at p181. 39 Re R (A minor) (Wardship: consent to treatment) [1992] Fam. 11.
become sectionable. The psychiatric unit applied to the Court in wardship proceedings to treat R without her consent.
It was held that R was not Gillick-competent to make an informed decision herself regarding her health-care because capacity cannot ‘fluctuate on a day to day or week to week basis.’40 The Court of Appeal could have stopped there and authorised R to be treated in her best interests because she lacked the capacity to decide for herself, but the Court went further and held that the decision in Gillick did not apply to the case before it because the young people considered in Gillick were not wards of the Court.41 The jurisdiction of the Court in wardship proceedings did not stem from the rights of parents, but from the Crown’s duty to protect children and was, therefore, more extensive than parental authority and, in wardship, the Court could override the decision of a minor, even if she was competent in the Gillick sense.42
The competent young person was thereby rendered more insecure of her autonomy rights in the health-care context. Since R lacked the capacity to decide in any event, it was wholly unnecessary to remove the right to self-determine from the competent child and, ‘to comply with the spirit of Gillick the courts should not claim a right to intervene in the lives of children which is denied to natural parents.’43A person with R’s symptoms would have been unable to make an informed treatment decision even if she had been an adult patient. She was suffering from an ‘impairment of, or a disturbance in the functioning of, the mind or brain,’44which prevented her from understanding the treatment options. This would have been the case if she had been aged forty, and in this sense the focus on her age and her minority status ‘confused the issue…(and)…was a red herring.’45
Controversially, the Court went further still and utilised a ‘keyholder’ analogy to explain the legal position regarding parental rights and the rights of the child to give an informed consent in the medical context. A valid consent operates as a ‘key’ allowing the health-care professional to lawfully treat the minor patient without worrying about potential litigation. An adult patient is the only ‘keyholder’ in this context, but ‘in the ordinary family unit where a young child is the patient, there will be two keyholders, namely the parents, with a several as well as a joint right to turn the key and unlock the door.’46 The decision does not sit comfortably with Gillick and places parental rights above those of even the competent child. It is difficult to see how the House of Lord’s ‘wide ranging approach to the issue of understanding (in
40 Ibid at [24]. 41 Ibid at [21]. 42 Ibid at [25]. 43 Andrew Bainham ‘The judge and the competent minor’ (1992) 108 LQR 194 at p196. 44 Mental Capacity Act 2005, s2(1). 45 Brazier & Bridge (n32) at p95. 46 Re R (n39) at [22].
Gillick)… can simply have been constructed to provide the doctor with protection from legal action.’47
In Re R, a distinction was drawn between ‘determination’ which was interpreted to be an absolute veto, and ‘consent’ which was interpreted narrowly, and amounted to the granting of permission to the doctor to provide the treatment lawfully.48 If the child consents but the parents oppose the treatment, the minor’s consent would be sufficient to allow the doctor to proceed to treat and the parental opposition would be of no legal effect. If the child refuses the treatment; however, and the parents’ consent, this too would be sufficient to authorise the doctor to treat the child lawfully. The parental right is strengthened by the decision, and leads to the wholly unsatisfactory result that the parental veto is given paramountcy in the face of the competent minor’s refusal, and the decision thereby ‘makes a nonsense of Gillick’.49
The accepted interpretation of the statutory rights of the sixteen and seventeen-year old patient was also rejected by the Court of Appeal in Re R. The keyholder analogy applied to s8 Family Law Reform Act 1969 and the parental right to consent persisted, even when the minor was sixteen or seventeen years of age.50 Whilst it is true that s8 does not refer specifically to refusals of consent, the settled interpretation was that ‘the section could (and perhaps should) be interpreted as encompassing the right to refuse.’51 If the doctrine of informed consent is the legal assertion of the value of autonomy, then it is hard to see how consent and refusal can be readily distinguished. If the right to consent to treatment is to have any meaning, it must follow that there is a concurrent right to refuse treatment.52Without the ability to lawfully refuse treatment, the right to consent is reduced to a right to accept the opinion of the treating clinician,53 and the idea that a young person may ‘competently consent to a treatment but not be competent to refuse it is palpable nonsense,’54 because consent and refusal are opposite sides of the same coin. The younger child – best interests
Where the child is younger and Gillick-competence is, therefore, not in issue, then the treating clinician should seek parental consent to administer lawful treatment to the minor child. Where the clinician and the parents are unable to agree on a treatment plan, the doctor can apply to the Court to exercise its inherent jurisdiction, or to make an order under Section 8 of the Children Act 1989 to allow her to treat the
47 Marc Stauch & Kay Wheat Text, cases and materials on medical law and ethics (5th edn Routledge 2015) at p178. 48 Re R (n39) at [23]. 49 Brazier & Cave (n25) at p467. 50 Re R (n39) at [24]. 51 Jonathan Montgomery ‘Consent to health-care for children’ (1993) 5 JCL 117 at p123. 52 Angela Holder, ‘Children and adolescents’ in Kopelman & Moskop (eds) Children and healthcare: Moral and social issues (Boston: Kluwer Academic 1989) at p163. 53 Donna Dickenson, ‘Children’s informed consent to treatment: Is the law an ass?’ (1994) 20 JME at p205. 54 John Harris, ‘Consent and end of life decisions’ (2003) 29 JME at p12.
child without parental consent. The Court will make the order it considers will best advance the child’s welfare.55
The case of Re T56 concerned a child who was born with a severe liver disease. If he did not undergo liver transplant surgery, the treating clinicians estimated he would die at approximately two and a half years of age. T’s parents, who were both health-care professionals, vehemently opposed the surgery and moved overseas with T. An order was sought for T to be returned to the jurisdiction and for the surgery to go ahead.
The Court held that the parental wishes should be respected given that T’s successful recovery from the transplant surgery depended upon the co-operation of his mother, and if it were ordered against her wishes, his future care would be compromised. Fearing that ordering the surgery in the face of parental opposition would cause family problems, the Court held that ‘the mother and child are one for the purposes of this unusual case…(and)…the welfare of the child depends on his mother.’57Strikingly, the Court appeared to place emphasis on the fact that T’s parents were medically qualified when considering what was in T’s best interests, thereby according their views more respect and it is submitted it is highly, ‘questionable whether such significance should…(be)…attributed to the parents’ profession.’58 The co-operation and commitment of parents is always necessary with any child who is unwell, and it is problematic that T was denied surgery with good prospects of success because of the parental right to objection. It is submitted undue weight was given to parental rights, and T’s welfare was dubiously inextricably linked with the wishes of his mother.
The Courts seem to take the view that parents generally are in the best position to know what treatment is in the best interests of their children, and there appears to be a general reluctance to overrule parental decision-making in this context.59 In the case of Ashya King, the parents disagreed with the clinicians’ treatment plan for their son and favoured a different treatment plan overseas. The Court supported the parental right to decide, holding the state had ‘no business interfering with the exercise of parental responsibility unless the child is suffering or is likely to suffer significant harm as a result’60of the unreasonableness of the parental care. Crucially though, the Court found the alternative treatment the parents preferred was ‘reasonable,’ even though it was not the favoured plan of the treating clinicians.
Charlie Gard61 was born in August 2016 with a rare disease which rendered him incapable of breathing unaided or from moving his arms and legs. He was deaf,
55 Children Act 1989, s1. 56 Re T (A minor) (Wardship: Medical Treatment) [1997] 1 All ER 906. 57 Ibid at [914]. 58 Marie Fox & Jean McHale, ‘In whose best interests?’ (1997) 60 MLR 700 at p702. 59 In the Matter of Ashya King (A Child) [2014] EWCH 2964. 60 Ibid at [31]. 61 Great Ormond Street Hospital v Yates [2017] EWCA Civ 410.
suffered recurrent epileptic fits and severe brain damage. The treating hospital deemed further treatment futile and sought an order from the Court that it would be both lawful and in the child’s best interests for the ventilation to be withdrawn and for treatment to be palliative. Charlie’s parents opposed the application, and wanted to take him to the United States to undergo experimental nucleoside therapy.
The case attracted enormous international media attention and high-ranking figures including the Pope and the President of the United States commented publicly on the plight of both Charlie and his parents62.The Court affirmed that where there is a disagreement between the parents and the treating clinicians regarding the treatment of a minor child, the Court makes the decision as to how the child shall be treated, and the Court would make the order it considered to be in Charlie’s best interests. Charlie’s welfare was the Court’s paramount consideration and the Court should not evaluate the reasonableness of Charlie’s parents case or ‘any other factor or filter before it embarks upon deciding what is in the best interests of the child.’63 The Court found in favour of the Hospital on the basis that Charlie did not realistically, have a reasonable alternative treatment, and the proposed alternative therapy would only serve to extend Charlie’s suffering. Charlie’s case went to the heart of where the boundaries lay between protecting children’s rights, promoting parental rights to make private family decisions, and when and how the state should intervene in those decisions. The enormous international public response to Charlie’s case illustrated this ‘and demonstrated that many consider it right to leave the final say about a child’s medical welfare to the parents.’64 Conclusion
Informed consent is a fundamental right enshrining the principle of autonomy and respect for personhood in the sphere of medical law. The decision in Gillick promoted a functional approach to assessing the capacities of children to decide what happened to their own bodies in the health-care context, and established the right of the mature child to decide for herself on matters relating to her own medical treatment and when she acquired the requisite level of understanding to exercise this right, any parental rights ceased to be of legal relevance. The case confirmed that parental rights exist only in so far as they promote the welfare interests of children, and thereby extended Parliament’s recognition that the decisions of sixteen and seventeen-year old patients should be accorded the same recognition as those of the adult patient.65
Unfortunately, subsequent decisions such as that of Re R have served to erode the respect accorded to the autonomy of the mature minor in favour of a more
62 Case Comment ‘Charlie Gard’ (2017) EHRLR 502 at p505. 63 Great Ormond Street Hospital v Yates (n61) at [94. 64 Cressida Auckland & Imogen Goold ‘Defining the limits of parental authority: Charlie Gard, best interests and risk of significant harm threshold’ (2018) LQR 37 at p41. 65 Family Law Reform Act 1969, s8.
paternalistic approach, returning decisional authority to the parents and to the Courts. It would have been preferable for the Courts to have treated R under the Mental Health Acts rather than using dubious logic to manipulate the nature of competence to retreat from Gillick, and render the mature minor insecure of her rights.
Where the child lacks capacity, parental consent is required to treat the child and where parents and clinicians disagree, the Courts will determine how the child is to be treated, and will base its decision on what it considers to be in the minor child’s best interests. The Courts have not always placed the interests of the child above those of the non-consenting parent; however, and Re T serves as an example of where T’s interests seemed to clearly indicate that surgery was in his best interests, and the parental rights were accorded too much respect by the Court. It is to be hoped that the decision in that case is an ‘idiosyncratic and anomalous judgement’66 and T’s interests were wrongly tied in with the wishes of his parents. It is submitted that the correct approach is that taken in the case of Charlie Gard where the parental wishes were carefully considered but overruled where the Court, as the final arbiter in cases of conflict, orders the treatment plan which best promotes the welfare of the child.
66 Jackson (n13) at p261.
Bibliography
Table of cases
Chatterton v Gerson [1981] QB 432.
Gillick v West Norfolk and Wisbech AHA [1985] 3 All ER 402.
Great Ormond Street Hospital v Yates [2017] EWCA Civ 410.
Hewer v Bryant [1970] 1 QB 357.
In the matter of Ashya King (A Child) [2014] EWCH 2964.
R V Donovan [1934] 2 KB 498.
Re MB (An Adult: Medical Treatment) [1997] 2 FLR 426.
Re R (a Minor) (Wardship: Consent to treatment) [1992] Fam.11.
Re T (adult: refusal of treatment) [1992] 4 All ER 649.
Re T (A minor) (Wardship: medical treatment) [1997] 1 All ER 906.
R V Howard [1966] 1 WLR 13.
Table of legislation
Children Act 1989.
Family Law Reform Act 1969.
Mental Capacity Act 2005.
Mental Health Act 1983.
Sexual Offences Act 2003.
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Fox, M & McHale, J ‘In whose best interests?’ (1997) 60 MLR 700.
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