Consent, Rights and Choices in Health Care for Children and Young People

. 2001.

Allen Levy, QC

Consent for Male Circumcision In the United Kingdom

Note:

The British Medical Association has published a guidance for doctors in the United Kingdom. The following is an extract of the passages regarding male circumcision:

As is discussed in later chapters, the law is changing to accommodate trends such as that of unmarried parenthood by re-examining the legal issue of parental responsibility and, in case law, by insisting that consent from one parent alone is insufficient for non-therapeutic interventions such as male infant circumcision (see section 6.1.1). In our view, while uncertainty remains regarding the extent to which practice will change in relation to minors' rights as a result of the

Human Rights Act, such rights are increasingly seen as an important matter for debate and re-evaluation, etc. It is conceivable, therefore, that as we become more accustomed to looking at a range of issues, such as health care, through the prism of human rights, views about parental authority over competent children will also undergo significant change.

Consent allows treatment to be given, but does not require health professionals to treat. A decision whether to provide treatment on the basis of consent from one parent may be influenced by the view of the other. Although the law does not require that parents agree, in practice doctors are reluctant to override the strongly held views of a parent, particularly where the benefits and burdens of the treatment are finely balanced and it is not clear what is best for the child. Disputes between parents can be difficult for everybody involved in the child's care. Health professionals need to be able to distinguish between a genuine concern of the dissenting parent and an objection that is simply an extension of a marital dispute. Discussion aimed at reaching a consensus should be attempted. If this fails, a decision must be made by the clinician in charge whether to go ahead despite the disagreement. The onus is then on the parent who refuses treatment to take steps to stop it. If the dispute is over a controversial, elective procedure, for example male infant circumcision for religious purposes, doctors must not proceed without the authority of a court. (Reference:

Re J (A Minor) (Prohibited Steps Order: Circumcision), sub nom Re J (Child's Religious Upbringing and Circumcision) and Re J (Specific Issue Orders: Muslim Upbringing and Circumcision) [2000] 1 FLR 571; [2000] 1 FCR 307; (2000) 52 BMLR 82. The BMA issues

guidance for doctors on male infant circumcision that is available on request and on the BMA website,

www.bma.org.uk.)

Note:

The book was written by a steering committee composed as follows:

Chairman:
Mr Allen Levy QC, Barrister and Recorder.

Members:
Dr Priscilla Alderson
Mr Phil Bates
Dr Ieuan Davies
Dr Donna Dickinson
Dr Elaine Gadd
Prof David Harvey
Ms Rachel Hodgkin
Mr Peter Honig
Ms Claire Johnston
Prof Neil McIntosh
Mr Jonathan Montgomery
Mr Michael Nicholls
Prof John Pearce
Prof Sir Michael Rutter
Dr Michael Wilks

Citation:

Levy A, et al. Consent, Rights and Choices in Health Care for Children and Young People. BMJ Books. 2001

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