Re L (Medical Treatment: Gillick Competency)
| Jurisdiction | England & Wales |
| Judgment Date | 1998 |
| Date | 1998 |
| Year | 1998 |
| Court | Family Division |
Child – Medical treatment – Child suffering grave and life-threatening injuries – Condition requiring surgical intervention involving blood transfusions – Child a Jehovah’s Witness – Refusing to consent to blood transfusions – Whether child ‘Gillick competent’ – Whether treatment should be authorised.
As a result of accidentally falling into a bath of very hot water, a girl aged 14 suffered very serious burns. Her condition was so grave that she needed medical treatment involving surgical intervention to save her life. The operations would require blood transfusions which the child would not consent to as she was a Jehovah’s Witness. The surgeon made it clear to the child that the operations and blood transfusions were necessary to save her life but, because of her age, he had not told her what would be the very distressing nature of her death. The hospital authority sought the leave of the court to administer blood transfusions in the course of essential medical treatment even though the child did not consent.
Held – In deciding whether a child was ‘Gillick competent’ there was a distinction between a child’s view against blood transfusions based on a sincerely and strongly held religious belief which did not lend itself in the child’s mind to discussion and the constructive formulation of an opinion which occurred with adult experience. In the present case the child had led a sheltered life and she had a very limited experience of life which limited her understanding of matters which were as grave as her present condition. Also, she had not been given all the details which it would be right and proper to have in mind when she stated that she was willing to face death rather than to have a blood transfusion. In the circumstances the child was not ‘Gillick competent’ and it would be ordered that she receive the proposed treatment.
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a ‘Gillick competent’ is described by Lord Donaldson of Lymington MR in Re R (a minor) (wardship: consent to treatment) [1992] 2 FCR 229 at 246 as—‘not merely an ability to understand the nature of the proposed treatment ... but a full understanding and appreciation of the consequences both of the treatment in terms of intended and possible side effects and, equally important, the anticipated consequences of a failure to treat.’
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Case referred to in judgmentR (a minor) (wardship: consent to treatment), Re[1992] 2 FCR 229, [1992] Fam 11, [1992] 4 All ER 177, [1991] 3 WLR 592, CA.
ApplicationA hospital authority applied for leave to administer blood transfusions in the course of essential life-saving surgical treatment of a child aged 14, who, as a Jehovah’s Witness, refused to consent to blood transfusions. The case was heard and judgment was given in chambers. The case is reported with the permission of Sir Stephen Brown P. The facts are set out in the judgment.
Simon Taylor (instructed by the Health Legal Services) for the health authority.
Caroline Harry Thomas for the Official Solicitor.
Jeremy Rosenblatt (instructed by Keppe Jones...
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