From the Guidelines
Fraser guidelines and Gillick competence refer to the same legal concept, but with slightly different names, where Gillick competence is the principle established in UK law that determines whether a child under 16 years old can consent to their own medical treatment without parental permission or knowledge, and the Fraser guidelines are a specific application of Gillick competence that relate particularly to contraceptive advice and treatment. The term "Gillick competence" comes from the 1985 case Gillick v West Norfolk and Wisbech Area Health Authority, where the House of Lords ruled that minors could consent to medical treatment if they had sufficient maturity and understanding 1. According to the guidelines, a young person under 16 may also have the capacity to consent, depending on their maturity and ability to understand what is involved, and if they are deemed competent and able to give voluntary consent, that consent will be valid and additional consent by a person with parental responsibility will not be required 1.
In practice, healthcare professionals use both terms, with Gillick competence referring to the broader principle of children's capacity to consent to medical treatment, while Fraser guidelines specifically address contraceptive services. The guidelines help practitioners assess whether a young person can receive contraceptive advice or treatment without parental consent. As stated in the guidelines, a capable child should understand the treatment and its effects, and the consequence of non-treatment, and if capacity fluctuates, the child should be considered as lacking capacity 1.
The most recent and highest quality study on this topic is from 2017, which provides guidance on consent for anaesthesia and states that 16- and 17-year-olds are presumed to have the capacity to consent to treatment, including the administration of an anaesthetic, as if they were adults 1. The study also emphasizes the importance of assuming capacity unless proven otherwise and providing all practicable help to make their own decision before being treated as lacking capacity 1.
Key points to consider when assessing a child's capacity to consent include:
- The child's maturity and ability to understand the proposed treatment
- The child's ability to weigh up the options and make a decision
- The severity of the condition being treated
- The potential risks and benefits of the treatment
- The child's right to confidentiality and a refusal to permit disclosure to parents.
Overall, healthcare professionals should use the Gillick competence and Fraser guidelines to assess a child's capacity to consent to medical treatment, and prioritize the child's best interests and well-being.
From the Research
Difference between Fraser guidelines and Gillick competence
- The Fraser guidelines and Gillick competence are two related but distinct concepts in the context of minors' access to contraceptive services.
- There are no research papers provided to directly answer the question about the difference between Fraser guidelines and Gillick competence 2, 3, 4, 5, 6.
- The provided studies focus on various aspects of contraception, including contraceptive methods, effectiveness, and adverse effects, as well as factors influencing contraception choice and use globally.
- However, none of the studies explicitly discuss the Fraser guidelines and Gillick competence, making it impossible to provide a detailed comparison based on the available evidence.