Consent
Children and young people under 18
For children and young people under 18, a parent or guardian can agree to treatment on the child’s behalf (in most cases).Children and young people under 18 going to the doctor
Children can make decisions about their own medical treatment if they’re capable of understanding its significance.If you want to go to the doctor on your own you’ll need to think about how you will pay for the doctor. Some doctors bulk bill under the government health system called Medicare. This means you won’t have to pay. In other cases, you’ll have to pay, but you can get some of the money refunded from Medicare.
You’ll need to show your Medicare card or your parent’s Medicare card when you go to the doctor.
If you’re over 15, you can apply for your own Medicare card. If you’re under 15, you’ll need to use your parent’s card. If you’re 14 and older, Medicare won’t give information about your treatment to your parents, but if you use your parent’s Medicare card, they may find out that you’ve seen a doctor.
Consenting to medical treatment as a child or young person
To consent to medical treatment (have capacity) you must be capable of making your own decision on what is proposed (forming a sound and reasoned judgment), which shows you understand the nature, consequences and risks of the treatment, and it’s in your best interests.The doctor will consider:
- your maturity and intelligence
- whether you understand what the recommended medical treatment is
- why the medical treatment is needed
- what the medical treatment involves, and
- any risks related to it, such as effects on your health, potential complications and also side effects.
Except for immediate, life-threatening emergencies, a doctor must get your consent for any medical treatment. Some doctors or hospitals may require your parents’ agreement if you’re under 18.
Whether you can consent to, or refuse medical treatment sometimes depends on the type of treatment you are getting. For minor medical treatment (eg treatment for colds or acne), you have the right to agree (consent) or refuse if you’re mature enough to understand the recommended treatment, its consequences and related risks.
For more complicated medical treatments (eg contraceptives), you may still have the right to agree to (consent) or refuse treatment without your parents’ consent if the doctor is satisfied that you understand the treatment and its consequences and related risks. The doctor must also believe that the procedure is in your best interests.
For ‘non-therapeutic’ treatments (eg sterilisation or gender reassignment operations), you must get the permission of a court or Tribunal—even if you have your parents’ consent. These are known as special medical procedures.
In some situations, you may not have the right to refuse a treatment, even if you fully understand the treatment and its consequences (eg refusing a blood transfusion on religious grounds or refusing treatment of eating disorders).
Your parents can only agree to or refuse medical treatment on your behalf if you aren’t mature enough to make your own decisions. In this case, the decision must be made in your best interests.
If there is disagreement between you, your parents and your doctor about treatment, a court may need to decide what will happen. The court must consider what is in your best interests when making its decision.
Special medical procedures For Children
There are some decisions about special medical procedures that can’t be decided by a parent or guardian or the child and must be decided by a court or Tribunal. These treatments are called special medical procedures and include:- sterilising a child who has a significant intellectual disability
- organ donation when a child is unable to give informed consent
- medical practitioners recommending life-saving treatment but parents or guardians refusing to agree to the treatment (eg parents refusing for a child to be put on life support)
- parents or guardians disagreeing about significant, recommended treatment/s
- sensitive or ethically controversial issues (eg gender decisions for a child born with both genitalia)
- Refusing treatment in a life-threatening situation (eg child suffers anorexia nervosa and refuses treatment).
- a parent
- a person authorised by a parenting order
- a child
- an independent children’s lawyer
- anyone concerned with the care, welfare and development of a child.
Consent and children
A parent or guardian of a child generally has authority to consent or refuse medical treatment on behalf of their child. However, a child under 18 can make their own medical decisions where they have sufficient understanding and intelligence to fully understand the treatment (see Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112 and Secretary, Department of Health & Community Services (NT) v JWB and SMB (Marion’s Case) (1992) 175 CLR 218).A variety of factors can impact on any assessment of the capacity of a child to provide consent to medical treatment including their age, maturity and the seriousness (or not) of the medical condition. For further details on medical treatment and children see:
- Qld Law Handbook – Parents, Children and the Law
- Qld Law Handbook – Medical Treatment
- Qld Health – Children and Youth Mental Health Service
Children’s Independent Patient Rights Advisor (IPRA)
Children’s IPRA An IPRA is an Independent Patients Right Advisor and their role is independent of the health service, and is to support a patient to have their voice heard by the health service.Children’s Health Queensland IPRA
Phone: (07) 3069 7104 / 0476 830 919
Email: CHQ_IPRA@health.qld.gov.au
See also our page Independent Patient Rights Advisor (IPRA)
Helplines
24-hour Helpline ServicesCYMHS Acute Response Team – 3068 2555
Lifeline crisis support and suicide prevention – 131 114
Health Hotline – 13 HEALTH (13 432 584) Kids Helpline telephone counselling service for people aged 5-25 – 1800 55 1800 Youthbeyondblue & beyondblue – 1300 224 636
Alcohol and Drug Information Service – 1800 177 833
Poisons Information Centre – 131 126
Other Helpline Services
Parentline 7 days a week from 8am to 10pm – 1300 30 1300 Eheadspace 7 days a week from 9am to 1am AEDST – 1800 650 890 NPS Medicine Mon to Fri 9am-5pm – 1300 MEDICINE (1300 633 424)
Useful Websites
Kids Helpline – kidshelpline.com.auParentline – parentline.com.au
ReachOut – au.reachout.com
ReachOut Parents – parents.au.reachout.com
Youthbeyondblue – youthbeyondblue.com
Beyondblue – beyondblue.org.au
Eheadspace – eheadspace.org.au
Raising Children – raisingchildren.net.au
COPMI – www.copmi.net.au
Choice and Medication – choiceandmedication.org/queenslandhealth
NPS MedicineWise – nps.org.au/
