Working with doctors Working for patients

 

...give them information at an appropriate time and pace...

Just like adult patients, children and young people want and need information about their health and should be involved in discussions about their care. However, it is important that they are not overburdened, and that information is provided in a manner appropriate to their understanding.

At times, parents may want to protect their children from upsetting or complex information. However, doctors have a duty to be honest with all their patients, and this includes children and young people. This can present a challenge if they are asked to withhold information, but it is important to bear in mind that the doctor's primary duty is to their patient.

This does not mean that the views of parents should be disregarded: they are an integral part of assessing a child's best interests. Nonetheless, doctors should not withhold information from a child or young person who is capable of understanding it, unless they ask not to be told, or unless providing the information would cause them serious harm.

This is why - when Andrew is seven years old - Dr Simpson assesses his capacity to understand the implications of his diagnosis, before agreeing with his parents' request not to inform him of the diagnosis.

As Andrew grows older, and develops a better understanding of his condition, Dr Simpson encourages him to speak to his parents, and they agree to work together to help Andrew understand his diagnosis and its implications.

...if a young person refuses treatment...

Doctors face a difficult dilemma when a young person with capacity refuses treatment that the doctor considers to be in their best interests. This is particularly significant when the treatment is necessary to save the young person's life. Doctors should respect a young person's views about their health, as they would any other patient's, but this must be balanced against the doctor's duty to act in their patient's best interests.

The law in this area is complex, and differs across the UK. You should seek advice if you think treatment is in the best interests of a competent young person who refuses. Having said that, it is usually preferable to try to resolve such issues informally.

It is essential that the young person, and their parents, have been provided with all the information they need to make an informed decision. Often, other members from the multi-disciplinary team may be better placed to provide this information to the young person.

This is why Dr Simpson asks a counsellor with experience in working with young people to speak to Andrew to try to identify his concerns, so that they can be appropriately addressed. By agreeing to involve Andrew in reviewing his treatment, Dr Simpson is demonstrating her respect for Andrew's views and ensures that he is involved in the decision-making process.