Paediatrics: The doctor–child relationship

The doctor–child relationship

Involving children in decision-making about their own care presents some problems. The law in England is not clear and relies on the clinician exer-cising clinical judgment. In general, consider:

·  Doctors should act in partnership with children whenever possible.

·  The Children Act (1989) states that children’s views should be heard.

·  The United Nations Convention on the Rights of the Child indicates that clinicians should give ‘due weight to the views of the child according to age and maturity’.

The Children Act 1989

The legal framework within which action takes place to safeguard children.

The key principles of this act include:

·  The welfare of the child is paramount.

·  Children are best brought up in their own home and agencies should seek to work in partnership with parents.

·  The social services authority has a duty to investigate the circumstances of individual children where there are reasonable grounds to believe that the child is at risk of suffering or suffers ‘significant hardship’.

Note the following:

·  ‘Harm’ is defined as ill-treatment (i.e. all forms of abuse) or impairment of health or development.

·  ‘Significant’ is not defined in the Act, but means considerable, noteworthy, or important.

The Children Act 1989 was added to in The Children Act 2004 which gave legal underpinning to ‘Every Child Matters: Change for Children’ (2004) and meant that from April 2006, education and social care services for children have been brought together under a director of children’s serv-ices in each local authority.

Closely linked to the Children Act are:

·  Protection of Children Act 1999.

·  Safeguarding Vulnerable Groups Act 2006.

·  The Children and Young Person Act 2008.

The Human Rights Act 1998

Public authorities must act consistently with the European Convention on Human Rights. Most relevant are the following.

·  Article 2: The right to life.

·  Article 8: The right to respect for private and family life.

·  Article 5: The right to liberty and security of person.

Article 3: That no one shall be subjected to torture or inhuman or degrading treatment or punishment.