MORE THAN half of GPs feel legally exposed when dealing with requests for contraception from teenagers aged 16 and under, according to a survey. The survey by doctors from the Trinity College Dublin GP training scheme and the Department of Public Health and Primary Care at the university, published in the latest issue of the Medico-Legal Journal of Ireland,reveals significant differences in the views of doctors and parents about what is currently legal when prescribing contraceptives for minors.
The age of consent for medical treatment in the Republic is 16 years.
However the current legal age for sexual intercourse is 17. But general practitioners are frequently consulted by patients aged less than 16 seeking medical care. This legal discrepancy represents a challenge for GPs, especially if the consultation relates to oral contraception or a request for “the morning after pill”.
Some doctors here rely on UK guidelines based on the Gillick case following a 1985 court ruling which stated: “a 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.”
However, these guidelines have no established validity in Ireland.
The 2009 survey of some 117 GPs and 171 parents found 34 per cent of parents felt a GP who prescribed to a girl aged 16 or younger without parental consent could be pursued legally. Some 54 per cent of GPs felt legally exposed when faced with the same clinical dilemma. When questioned about current prescribing practice, 83 per cent of GPs had prescribed the pill to a girl aged under 16.
When asked whether a girl aged under 16 could make her own decision that she needed an oral contraceptive or emergency contraception, only 22 per cent of GPs and 10 per cent of parents selected the “depends on the girl’s maturity” option as outlined in the Gillick guidelines. Commenting on the research, Dublin GP and lead author Dr Des McMahon said during his training he was struck about the lack of clarity around the issue.
Dr McMahon, who is also a qualified solicitor, said “we need the view of parents and their contribution to the debate.” Current Medical Council guidelines state: “In exceptional circumstances a patient under 16 might seek to make a healthcare decision on their own without the knowledge of their parents. In such cases you should encourage the patient to involve their parents in the discussion, bearing in mind your responsibility to act in the patient’s best interests.”
Last December the Law Reform Commission published a consultation paper Children and the Law: Medical Treatment. It proposes a change to the law to allow patients aged 14 to 16 give consent provided they have the capacity to understand the nature and consequences of the treatment.
