Children's informed consent and the role of medical professions : On the Gillick Competence in the U.K.

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  • 子どもの同意能力評価をめぐる倫理的問題と医療専門職の役割 : イギリスのGillick Competenceの議論を手がかりとして

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Abstract

The purpose of this paper is to analyze the Gillick Competence case in the U.K., focusing on children's consent and the assessment of competence procedures in the case of medical treatment and their participation in medical studies. The informed consent of participants is required when undergoing medical treatment and study. However, when a child becomes the subject of the treatment and study, consent is often given only by the parents as a proxy consent in Japan. In recent years the concept of informed assent for children has been argued in the pediatrics domain in Japan with respect to individual children's rights, but the decision-making power of a child patient and the parents and its fitness for the purpose of medical practitice come into ethical conflict when a patient does not agree with the treatment policy of the medical professionals and also when the wishes of the child are different from those of the parents. In the U.K., the Gillick rule meant a child could make a self-determining medical decision without the agreement of the parents. Whether or not minors can give consent themselves depends on their degree of competence. However, the opinions of the parents, the child and medical professions regarding the child's best course of treatment sometimes come into conflict. First, I will provide a general outline of the legal concept of children's rights in medical treatment and the notions and procedures of the Gillick Competence. Second, I will examine previous studies concerned with the assessment procedure of the children's competence and clarify legal issues of the Gillick Competence to consider its application in several medical lawsuits in the U.K.. Third, I would like to evaluate the capacity for self-determination in children, and their ability to give consent to medical treatment including the involvement of the patients, the patient's family and the medical professions.

Journal

  • Bioethics

    Bioethics 22 (1), 67-74, 2012

    Japan Association for Bioethics

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