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12.2.13 Practice Guidance: Medical Examinations for Children Suspected of Being Abused

SCOPE OF THIS CHAPTER

Purpose

This practice guidance is intended to provide clarity in respect of consent and the parental/carer role in taking children who are suspected of being abused for medical examinations.

Underpinning Principle

That the needs of the child are paramount and medical examinations must be conducted in a way that both promotes the safety and welfare of children and mitigates against avoidable distress to them.

This chapter was introduced into the manual in March 2013.

RELATED CHAPTERS

Alcohol Misusing Parents/Carers Procedure


Contents

  Practice Issue One - Parental/Carer Presence During Medical Examinations
  Practice Issue Two - Parental Consent to Examination


Practice Issue One - Parental/Carer Presence During Medical Examinations

In order to reassure and support children during medical examinations, it is important that a familiar adult, preferably a parent or carer, is present during medical examinations. It is recognised there will be occasions when it is not deemed to be in the child’s best interest for their parent or carer to be present.  In such circumstances, every effort should be made to identify an alternative familiar adult.

It is accepted that where a parent or carer is suspected or alleged to have caused the harm, their attendance at medical examinations will require careful management and planning. Agreement should be sought by the social worker as to the parent and carer’s level of participation in the process in advance of any action.


Practice Issue Two - Parental Consent to Examination

A multi-agency Strategy Discussion/Meeting prior to the medical examination should include a decision as to how parental consent should be sought and include how, when and by whom a parent/carer will be informed of the concerns or allegations. The general assumption is that parental consent should be sought.

When a decision is made not to inform a parent, it should be exceptional, defendable and proportionate. This should be clearly recorded as part of the Strategy Discussion and this decision should be discussed with the examining doctor prior to the child being taken to the hospital.

In most instances a parent will consent to medical examination. In cases where parental consent is sought and refused, and where urgent treatment is not thought to be necessary, the medical examination should be delayed until an appropriate order is obtained by the Local Authority. All actions and decisions should be recorded in detail.

Remember…

Parental consent for the medical examination of a child must be valid consent, which is both informed and given freely.

A young person under the age of 16 years has the legal capacity to consent to a medical examination where, in the opinion of the examining doctor, he/she is capable of understanding the nature and possible consequences of such an examination – known as being Fraser Competent.

A young person with learning difficulties, even if over 16 years, may not be able to give informed consent. In exceptional cases, a court order may need to be obtained.

Equally, where a young person is able to give their own consent they are also able to refuse consent.

End