The High Court judgement in Bell V Tavistock was overturned today following an appeal heard in June.
The Bell V Tavistock case centered around the question of whether puberty blockers could be prescribed to under-18s with gender dysphoria. It is related to Gillick competence, the legal principle governing under what circumstances under-16s can consent to medical treatment in their own right.
For the latter reason the case was considered important in areas related to medical treatment other than puberty blockers, especially if such treatment could be regarded as experimental, or life changing, for instance the MRNA gene therapy jabs currently being rolled out to children aged 12 to 15 years old.
The Court at first instance had said that “Where the decision is significant and life changing then there is a greater onus to ensure that the child understands and is able to weigh the information” . It indicated that court approval to puberty blocking treatment should be sought, before the treatment was given to a person under 18, not just under 16.
This decision was overturned today, and in this case means people under 16 are once again considered to be capable of giving consent to receiving puberty blockers. However, that consent must of course be informed, and a child must be deemed Gillick competent.
The appeal did nothing to change the rules around Gillick competency, which are well established. Here is a paragraph from the appeal judgement which we have circled in red.
Note the confirmation from the court that individual practitioners will be liable if it is proved that informed consent was not obtained from a child under Gillick principles.
Informed Consent. What is it?
Consent to treatment means a person must give permission before they receive any type of medical treatment, test or examination.
This must be done on the basis of an explanation by a clinician.
Consent from a patient is needed regardless of the procedure, whether it’s a physical examination, organ donation or something else.
The principle of consent is an important part of medical ethics and international human rights law.
For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision.
The meaning of these terms are:
– voluntary – the decision to either consent or not to consent to treatment must be made by the person, and must not be influenced by pressure from medical staff, friends or family (dare we say this includes the gov and main stream media?)
– informed – the person must be given all of the information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead
– capacity – the person must be capable of giving consent, which means they understand the information given to them and can use it to make an informed decision
Consent should be given to the healthcare professional responsible for the person’s treatment.
This could be a:
- nurse arranging a blood test
- GP prescribing new medication
- surgeon planning an operation
If a person changes their mind at any point before the procedure, they’re entitled to withdraw their previous consent.
Children and young people
If they’re able to, consent is usually given by patients themselves.
But someone with parental responsibility may need to give consent for a child up to the age of 16 to have treatment.
Like adults, young people (aged 16 or 17) are presumed to have sufficient capacity to decide on their own medical treatment, unless there’s significant evidence to suggest otherwise.
Children under the age of 16 can consent to their own treatment if they’re believed to have enough intelligence, competence and understanding to fully appreciate what’s involved in their treatment. This is known as being Gillick competent. We explain this below.
Gillick competency applies mainly to medical advice, but it is also used by practitioners in other settings. For example, if a child or young person:
– would like to have therapeutic support but doesn’t want their parents or carers to know about it
– is seeking confidential support for substance misuse
– has strong wishes about their future living arrangements which may conflict with their parents’ or carers’ views.
Medical professionals need to consider Gillick competency if a young person under the age of 16 wishes to receive treatment without their parents’ or carers’ consent or, in some cases, knowledge.
If the young person has informed their parents of the treatment they wish to receive but their parents do not agree with their decision, treatment can still proceed if the child has been assessed as Gillick competent.
There is specific guidance for medical professionals on using Gillick competence. However, there is no set of defined questions to assess Gillick competency.
Professionals need to consider several things when assessing a child’s capacity to consent, including:
the child’s age, maturity and mental capacity
their understanding of the issue and what it involves – including advantages, disadvantages and potential long-term impact
their understanding of the risks, implications and consequences that may arise from their decision
how well they understand any advice or information they have been given
their understanding of any alternative options, if available
their ability to explain a rationale around their reasoning and decision making.
Consent is not valid if a young person is being pressured or influenced by someone else.
Children’s capacity to consent may be affected by different factors, for example stress, mental health conditions and the complexities of the decision they are making. The same child may be considered Gillick competent to make one decision but not competent to make a different decision.
Young people also have the right to seek a second opinion from another medical professional (General Medical Council, 2020).
In a nutshell Gillick competency is informed consent, and making sure a person under 16, has given the same. Remember, part of obtaining informed consent from anyone, including a child, means the person or child concerned, must be given all of the information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead.
Given all of the above we would like to share with you what the government deems to be sufficient information for 12-15 years old, to enable them to give full, free and informed consent to the experimental MRNA gene therapy jabs.
When you read the PDF you will see that there is no mention of any risk of myocarditis, clots, fertility issues, and neither is it stated that the long term side effects of the jab are unknown.
There is nothing about minimal CV risk for children either.
This document is not therefore sufficient to meet the obligations surrounding informed consent. This would mean a child could not be Gillick competent, as informed consent cannot be given by them, in view of the information provided in the government leaflet.
The information provided is at best disingenuous, but it is also dangerous. It also places medical practitioners and those administering the jabs squarely in the firing line for any harm to children as a result of the jab being given to them. Liability is likely to also extend to head teachers and governors, if they allow a vaccination centre to be opened on school premises, or allow the jabs to happen in school, given their duty of care to children whilst on school premises.
There may be no liability for manufacturers, even the government, as in attempts to absolve themselves of responsibility, indemities have been given to jab manufacturers. However, doctors, nurses, teachers etc, can be held personally liable for breaching informed consent.
Given no one knows the long term effects of the jabs, the benchmark for informed consent simply cannot be met, in our opinion. There may, therefore, be a raft of cases in the coming months, if children are harmed.