End of life care: Children and young people who lack capacity

1. 104. If a child lacks capacity to consent, you should discuss with their parents the treatments you assess to be clinically appropriate, and seek their consent to the treatment they judge to be in the child’s best interests. It is usually sufficient to have consent from one parent, but if more than one person holds parental authority you should encourage them to reach a consensus. If after discussion, you and the parents reach a consensus that life-prolonging treatment would not be in the child’s best interests and the treatment is withdrawn or not started, you must make sure that any distressing symptoms are addressed and the child is kept as comfortable as possible. You must monitor the child’s condition and be prepared to reassess the benefits, burdens and risks of treatment in light of changes in their condition. You must keep the parents fully involved.
2. 105. If a young person aged 16 or 17 lacks capacity, in Scotland you can make decisions on the same basis as for an adult who lacks capacity to decide (see paragraphs 15-16). In England, Wales and Northern Ireland, you should follow the guidance at paragraph 104, but if a parent is not available you can make the decision about treatment and care following the guidance at paragraph 16(f).