Part 2
Dr Abbott is concerned by Roger’s account of events and by the suggestion that similar things have happened between Paul and his father in the past. She has concerns about Paul’s safety and judges that it is important for her to communicate with him directly. She also feels it is important to communicate with Paul without his uncle in the room, and asks Paul if he would be happy to do this, to which he agrees after some initial hesitation.
Knowing that the interpreter has been delayed, Dr Abbott checks Paul’s medical record to find out how the surgery would normally manage a consultation with Paul if an interpreter was not immediately available. Paul’s medical record shows that whilst British Sign Language is his preferred method of communication he also has written English skills and that written notes can be used to communicate with him as an emergency measure. Dr Abbott decides to use these methods to communicate with Paul.
Once Roger has left the room, Dr Abbott communicates with Paul in writing, noting down some questions on a pad. Paul replies by writing out his answers. However Dr Abbott finds it difficult to communicate fully with Paul in this way and also thinks that Paul seems uncomfortable answering questions about sensitive matters in writing. Dr Abbott’s concerns are not allayed in the course of the exchange and she feels it is necessary to speak to him in more depth with the help of an interpreter.
What should Dr Abbott do next?
- Should she bring Roger back into the room to interpret as an emergency measure?
- Should she end the consultation and ask Paul to return when an interpreter is available?
- Should she ask Paul to wait for the interpreter to arrive?
In paragraph 13 of Protecting children and young people: the responsibilities of all doctors, we say that if abuse or neglect is suspected, doctors must not rely on family members to interpret for each other. We also say in paragraphs 15 and 16 that doctors must listen to children and young people, and take their views into account when assessing their best interests, even if they are not mature enough to make decisions for themselves.
In appendix 1, we give advice on assessing a young person’s capacity to make decisions. It can be presumed that a young person has capacity to consent at the age of 16 years.