This case has set out a test that assesses the young person’s level of understanding and maturity in regard to the treatment that is being proposed. There is no fixed age at which it is possible to say that a child is mentally capable of understanding the nature of medical treatment and therefore capable of providing consent. The competence to consent is thus to be based upon the level of understanding demonstrated by the child. Hence, under this test, minors are effectively presumed to be incompetent unless they fully understand the nature of treatment and its effects, as also the consequences of refusing such treatment.
According to Lord Scarman, the children must demonstrate both understanding of the treatment, as well as the maturity to understand its other implications, such as moral and emotional ramifications of the decision3. Such an evaluation of minors to assess whether they are Gillick competent requires a medical practitioner to determine if the minor is mature enough to provide consent and autonomy in decision making can be allowed only when a minor can demonstrate such understanding of the nature and effects of treatment4. However, in contrast to Lord Scarman’s views, Lord Fraser stated that a young person is capable of consenting to medical treatment if he or she is able to understand what is being proposed and can express his or her views clearly in this regard. However, this was to be subject to the medical practitioner deeming such treatment or refusal of treatment to be in the patient’s best interests.5
In the case of Re S (A Minor)(Consent to Medical Treatment)6the patient S was suffering from thalassaemia, yet continually .refused blood transfusions which would have helped in the management of the condition. In this case, S was not judged to be Gillick competent on the basis that she could not fully comprehend the implications of her continued refusal of treatment. .