quarta-feira, 29 de abril de 2015

Gillick Competence

Gillick competence is a term originating in England and is used in medical law to decide whether a child (16 years or younger) is able to consent to his or her own medical treatment, without the need for parental permission or knowledge.
The standard is based on a decision of the House of Lords in the case Gillick v West Norfolk and Wisbech Area Health Authority[1985] (1985) 3 All ER 402 (HL). The case is binding in England and Wales, and has been approved in Australia, Canada and New Zealand. Similar provision is made in Scotland by The Age of Legal Capacity (Scotland) Act 1991. In Northern Ireland, although separate legislation applies, the then Department of Health and Social Services Northern Ireland stated that there was no reason to suppose that the House of Lords' decision would not be followed by the Northern Ireland Courts. (Wikipedia)

    Gillick (A.P.) (Respondent)
    West Norfolk and Wisbech Area Health Authority and the
    Department of Health and Social Security (Appellants)
    Die Jovis 17° Octobris 1985
The main question in this appeal is whether a doctor can
lawfully prescribe contraception for a girl under 16 years of age,
without the consent of her parents. The second appellant, the
Department of Health and Social Security ("the D.H.S.S.")
maintains that a doctor can do so. The respondent, Mrs. Gillick,
maintains that he cannot. The first appellant, West Norfolk and
Wisbech Area Health Authority, was not represented when the
appeal reached this House, but in the Court of Appeal they were
represented by the same counsel as the D.H.S.S.

Treatment for gender dysphoria in children: the new legal, ethical and clinical landscape

Malcolm K Smith and Ben Mathews

Med J Aust 2015; 202 (2): 102-104.  doi: 10.5694/mja14.00624

  • Gender dysphoria is a condition in which a child's subjectively felt identity and gender are not congruent with her or his biological sex. Because of this, the child suffers clinically significant distress or impairment in social functioning.
  • The Family Court of Australia has recently received an increasing number of applications seeking authorisation for the provision of hormones to treat gender dysphoria in children.
  • Some medical procedures and interventions performed on children are of such a grave nature that court authorisation must be obtained to render them lawful. These procedures are referred to as special medical procedures.
  • Hormonal therapy for the treatment of gender dysphoria in children is provided in two stages occurring years apart. Until recently, both stages of treatment were regarded by courts as special medical treatments, meaning court authorisation had to be provided for both stages.
  • In a significant recent development, courts have drawn a distinction between the two stages of treatment, permitting parents to consent to the first stage. In addition, it has been held that a child who is determined by a court to be Gillick competent can consent to stage 2 treatment.
  • The new legal developments concerning treatment for gender dysphoria are of ethical, clinical and practical importance to children and their families, and to medical practitioners treating children with gender dysphoria. Medical practitioners should benefit from an understanding of the recent developments in legal principles. This will ensure that they have up-to-date information about the circumstances under which treatment may be conducted with parental consent, and those in which they must seek court authorisation.