0-18 years guidance: If a young person refuses treatment

1. 30. Respect for young people’s views is important in making decisions about their care. If they refuse treatment, particularly treatment that could save their life or prevent serious deterioration in their health, this presents a challenge that you need to consider carefully.
2. 31. Parents cannot override the competent consent of a young person to treatment that you consider is in their best interests. But you can rely on parental consent when a child lacks the capacity to consent. In Scotland parents cannot authorise treatment a competent young person has refused.¹⁰ In England,Wales and Northern Ireland, the law on parents overriding young people’s competent refusal is complex.¹¹ You should seek legal advice if you think treatment is in the best interests of a competent young person who refuses.¹²
3. 32. You must carefully weigh up the harm to the rights of children and young people of overriding their refusal against the benefits of treatment, so that decisions can be taken in their best interests.¹³ In these circumstances, you should consider involving other members of the multi-disciplinary team, an independent advocate, or a named or designated doctor for child protection. Legal advice may be helpful in deciding whether you should apply to the court to resolve disputes about best interests that cannot be resolved informally.
4. 33. You should also consider involving these same colleagues before seeking legal advice if parents refuse treatment that is clearly in the best interests of a child or young person who lacks capacity, or if both a young person with capacity and their parents refuse such treatment.¹⁴

For further guidance on these issues see GMC guidance on consent and treatment and care towards the end of life.