Re-examining Children's Consent to Medical Treatment

The question of consent to the medical treatment of children is looked at across the four disciplines of law, medicine, psychology and philosophy. The conclusion is reached that while there is a remarkable consensus on the issues considered to be important, none of the disciplines provides a complete answer to the problems involved. As an experiment, reference is made throughout the article to various literary conceptions of childhood. It is hoped that some of these may give cause for thought about how children are treated by the professions. The article was prepared for publication before release of the judgements of the High Court in Re Marion in May 1992 (renamed Secretary, Department of Health and Community Services v JWB and SMB on appeal). In the appeal a majority of the High Court followed the Full Court of the Family Court in Re Marion and confirmed that judicial consent is required for the medical treatment of children in some cases. The notion of treatment being therapeutic or non-therapeutic was not accepted, the majority preferring to rest judgement on assessments of the risks and gravity of consequences of a wrong decision (JWB and SMB 79,180 and 79,206–7). There are many other points of interest discussed by the High Court, for example, Brennan J's comments on the absurdities of the concept of substituted consent (79,196–7), Deane J's acceptance that the issues involved were moral and social and therefore beyond legal competence (79,208) and McHugh J's understanding of the sources of the parental power to consent (79,214). Although adding authority to some of the views expressed in the Full Court of the Family Court, the judgements of the High Court do not dispose of debate on the issues raised in the article.     

Research with children: sharing the dilemmas

This paper identifies a number of significant gaps between the principles of good practice in research with children and the practical realities of conducting a research project with children. The context of the discussion is an ongoing research study of children and young people in Scotland with a parent or carer with HIV. The paper argues that conducting research with what is a hidden (and in many ways secret) population throws into sharp relief some difficulties and contradictions that are at the heart of the research process. The paper does not intend to present easy answers to the complex questions that it raises: the research project it describes is ongoing and not yet at the stage of disseminating findings in any definitive way. Moreover, it seems likely that there are no answers to the questions raised, but that the act of posing the questions may contribute to the development of better, more reflexive research with children.