Religious Beliefs and Teenage Refusal of Medical Treatment

Published date01 July 1999
Date01 July 1999
Religious Beliefs and Teenage Refusal of Medical
Caroline Bridge*
More than a decade ago the House of Lords in Gillick vWest Norfolk and Wisbech
Area Health Authority1appeared to grant mature minors the right to make
independent decisions. The judgment was widely regarded as a triumph for
children’s rights and was quickly followed by legislative measures designed to
enhance the status of children’s wishes and feelings2and recognise their rights to
participate in decision-making.3Adolescent autonomy in medical matters looked
set to become a reality when a series of cases during the 1990s revealed the
complexities and uncertainties inherent in the Gillick decision.4In an apparent
‘reversal of fortune’ judges proceeded to overrule the medical decisions of older
children in favour of the clinical judgments of their doctors. The welfare of the
child appeared, superficially at least, to have overruled any newly acquired
autonomy rights. Subsequent academic debate sought to analyse the diverse
concerns which motivated the apparent retreat from Gillick.5First, it focused on
the socio-legal and medical factors responsible for triggering teenage refusal of
treatment6and, secondly, it sought to unravel the ethical concept of autonomy in
relation to young people.7It is now apparent that cases where legal intervention has
been prompted by the young person’s refusal to accept treatment fall into one of
two categories: (1) the young person concerned has either been mentally disturbed
or mentally ill thus rendering the objection to treatment invalid; or (2) the refusal
has been prompted by a religious belief which denounces the specific form of
treatment. In the former category all the teenagers were afflicted with defects in
reasoning and control and lacked the capacity to make a true choice. The
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. 585
*Faculty of Law, University of Manchester.
1 [1986] AC 112.
2 See, for example, Children Act 1989 s 1(3) where the court is directed, in prescribed circumstances, to
have regard to ‘the ascertainable wishes and feelings of the child concerned’ (considered in the light of
his age and understanding).
3 The United Nations Convention on the Rights of the Child, Art 12(1).
4 See Re R (A Minor) (Wardship: Medical Treatment) [1992] 1 FLR 190; Re W (A Minor: Medical
Treatment) [1993] 1 FLR 1; South Glamorgan County Council vW and B [1993] 1 FLR 574; Re K,W
and H (Minors) (Medical Treatment) [1993] 1 FLR 854; Re E (A Minor) (Wardship: Medical
Treatment) [1993] 1 FLR 386; Re S (A Minor) (Consent To Medical Treatment) [1994] 2 FLR 1065;
Re C (Detention: Medical Treatment) [1997] 2 FLR 180.
5 See G. Douglas ‘The Retreat from Gillick’ (1992) 55 MLR 569; N. Lowe and S. Juss ‘Medical
Treatment – Pragmatism and the Search for Principle’ (1993) 56 MLR 865; J. Murphy ‘W(h)ither
Adolescent Autonomy’ [1992] JSWFL 529; M. Brazier and C. Bridge ‘Coercion or Caring: Analysing
Adolescent Autonomy’ (1996) Legal Studies 84.
6 See C. Bridge ‘Adolescents and Mental Disorder: Who Consents to Treatment?’ (1997) Medical Law
International 51.
7 See Brazier and Bridge n 5 above.

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