Gillick v West Norfolk and Wisbech Area Health Authority
[1986] AC 112
判决理由
A child under 16 can consent to medical treatment (including contraceptive advice and treatment) without parental knowledge or consent, provided the child has sufficient understanding and intelligence to fully understand what is proposed. This is known as 'Gillick competence'. Parental rights diminish as the child matures and are justified only insofar as they are needed for the child's protection.
事实
Mrs Gillick, a mother of five daughters under 16, sought a declaration that a Department of Health circular was unlawful. The circular advised doctors that in exceptional circumstances they could provide contraceptive advice and treatment to girls under 16 without parental consent. Mrs Gillick argued this undermined parental rights and was unlawful.
判决摘要
The House of Lords held (by 3–2) that the circular was lawful. Lord Scarman held that a minor could consent to medical treatment provided they had sufficient understanding and intelligence to enable them to understand fully what was proposed. This is a question of fact in each case. Parental rights do not exist for the benefit of the parent but for the benefit of the child, and they yield to the child's right to make their own decisions when the child achieves sufficient understanding. Lord Fraser set out guidelines for doctors providing contraceptive advice to under-16s (the Fraser guidelines).
关键引述
"The parental right to determine whether or not their minor child below the age of 16 will have medical treatment terminates if and when the child achieves a sufficient understanding and intelligence to enable him or her to understand fully what is proposed."
— Lord Scarman
"Parental rights are derived from parental duty and exist only so long as they are needed for the protection of the person and property of the child."
— Lord Scarman
后续处理
Gillick competence is applied across all areas of children's healthcare and beyond — it is a general principle of capacity for minors.
In Re R [1992] and Re W [1993], the Court of Appeal held that while a Gillick-competent child can consent to treatment, a refusal of treatment can be overridden by a person with parental responsibility or by the court.