Family Law Reform Act. Section 8. 1969.

Gillick v West Norfolk and Wisbech AHA. 1986;

Kennedy I, Grubb AOxford: OUP; 1998

Larcher V, Hutchinson A How should paediatricians assess Gillick competence?. Archives of disease in childhood. 2010; 95:(4)307-311

Mental Capacity Act. Section 1. 2005.

R (on the application of Axon) v Secretary of State for Health. 2006;

Re R (A minor) (Wardship Consent to Treatment). 1992;

Convention on the Rights of the Child adopted under General Assembly resolution 44/25. 1989;

Assessing Gillick competence

02 April 2017
Volume 25 · Issue 4


Recently released figures from the Office for National Statistics (2016) show that some 4160 girls under 16 became pregnant in England and Wales in 2014. To manage teenage pregnancies effectively, midwives must be able to assess the child's competence to consent to their maternity care.

The United Nations Convention on Children's Rights defines a child as any person under 18. It requires that childhood is recognised as a developmental period and that our domestic laws must be developed ‘in a manner consistent with the evolving capacities of the child’ (United Nations, 1989). As children grow and develop in maturity, their views and wishes must be given greater weight and their development towards adulthood must be respected and promoted.

This key principle is reflected in consent law as applied to children. Kennedy and Grubb (1998) argue that children pass through three developmental stages on their journey to autonomous adulthood:

The issue over whether a girl under 16 has the necessary competence to consent to maternity care was decided by the House of Lords in Gillick v West Norfolk and Wisbech AHA (1986), when a mother of girls under 16 objected to Department of Health advice that allowed doctors to give contraceptive advice and treatment to children without parental consent. Their Lordships held that a girl under 16 had the legal competence to consent to examination and treatment if they had sufficient maturity and intelligence to understand the nature and implications of that treatment.

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