Adolescent Autonomy, Detention for Medical Treatment and Re C

AuthorPeter De Cruz
DOIhttp://doi.org/10.1111/1468-2230.00225
Date01 July 1999
Published date01 July 1999
Adolescent Autonomy, Detention for Medical Treatment
and Re C
Peter de Cruz*
Does an adolescent suffering from anorexia have the ‘right’ to refuse life-saving
treatment and have the ‘right’ to die?1Does she have autonomy in these
circumstances – the right to grant or refuse medical treatment? Do English courts
have the right to authorise that adolescent’s detention and the use of reasonable
force to effect life-saving treatment? These issues faced the High Court in the case
of Re C,2concerning C, a 16-year-old anorexic girl. It aroused considerable media
attention because it was reported as being the first case where a court had ruled that
it had jurisdiction to authorise the forcible detention of a child at common law (and
therefore outside the Mental Health Act) in order for that child to receive medical
treatment. Yet this was not the first such case. In Re W (A Minor) (Consent to
Medical Treatment)3the Court of Appeal had declared (somewhat controversially)
that while 16-year-olds could consent to treatment they could not refuse such
treatment if the circumstances were such that the court considered them incom-
petent to do so and where it was not in their best interests to do so. Other cases
have also been decided on the same lines as Re C where psychotic adolescents
were involved.4Nevertheless, Re C is a case worthy of scrutiny, because it clarifies
the scope of the court’s exercise of its inherent jurisdiction under section 100 of the
Children Act 1989 (the 1989 Act) and confirms the test of competence that should
be applied to children in these circumstances. It also provides guidance on the way
in which an order should be framed and seeks to clarify the relationship between
the court’s inherent jurisdiction and the statutory scheme under section 25 of the
1989 Act.
The facts
C, a girl aged 16, showed early symptoms of anorexia nervosa at the age of 12. She
was one of five children in a family described as ‘highly dysfunctional’,5and had
social services involvement since 1982, and a history of being sexually abused by
her brother, perpetrated over a substantial period. C suffered from anorexia for two
ßThe Modern Law Review Limited 1999 (MLR 62:4, July). Published by Blackwell Publishers,
108 Cowley Road, Oxford OX4 1JF and 350 Main Street, Malden, MA 02148, USA. 595
* Law School, Staffordshire University.
Thanks are due to Roger Brownsword for his very helpful comments on earlier drafts.
1 See H. Houghton-James ‘The Child’s Right to Die’ [1992] Fam Law 350.
2Re C (Detention: Medical Treatment) [1997] 2 FLR 180.
3 [1993] 1 FLR 1; sub nom Re W (A Minor) (Medical Treatment) [1992] 4 All ER 627.
4 See the pre-Children Act 1989 case of Re R (A Minor) (Wardship: Medical Treatment) [1991] 4 All ER
177; for a sample of academic commentary see A. Bainham ‘The Judge and the Competent Minor’
(1992) 108 LQR 194; J. Urwin ‘Re R: The Resurrection of Parental Powers?’ 8 Professional
Negligence 69; J. Murphy ‘W(h)ither Adolescent Autonomy?’ [1992] JSWFL 529; see also Re K, W
and H [1993] 1 FLR 854; and South Glamorgan CC vW&B[1994] 1FLR 574 ; on the latter case, see
C. Lyon ‘What’s Happened to the Child’s Right to Refuse?’ (1994) JCL 84; for an analysis of all these
cases and the concept of adolescent autonomy, see M. Brazier and C. Bridge ‘Coercion or Caring:
Analysing Adolescent Autonomy’ (1996) Legal Studies 84, especially at 85–93.
5per Wall J, n 2 above, 184.

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT