Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112 (HL)

Facts

  • Mrs. Gillick, a mother of five, challenged guidance from the Department of Health and Social Security that permitted doctors to provide contraceptive advice and treatment to girls under sixteen without parental consent.
  • The challenge was prompted after one of Mrs. Gillick's daughters received such advice while under the age of sixteen.
  • Mrs. Gillick sought a declaration that the guidance was unlawful, arguing it infringed parental rights and responsibilities.
  • The case centered on the balance between parental authority and a minor’s autonomy to make decisions regarding their own medical treatment.
  • The legal dispute raised questions about the competence of children to make informed medical decisions, especially in reproductive health, and the duties of healthcare professionals.

Issues

  1. Whether a parent has an absolute right to control a minor’s ability to receive medical treatment, specifically contraceptive advice and services.
  2. Whether doctors providing contraception or advice to those under sixteen without parental consent commit a criminal offence, particularly under the Sexual Offences Act 1956.
  3. Whether the Department of Health’s guidance undermined parental rights and responsibilities in relation to their children’s healthcare decisions.
  4. To what extent children possess legal capacity and autonomy to consent to medical treatment.

Decision

  • The House of Lords dismissed Mrs. Gillick’s application for a declaration.
  • It was held that parental rights are not absolute but exist to safeguard the child’s best interests.
  • A minor can consent to their own medical treatment if they are judged to have sufficient understanding and intelligence to comprehend the nature and implications of that treatment (now termed "Gillick competence").
  • Providing contraceptive advice or treatment to under-16s, when intended for their health and welfare, does not contravene criminal law or amount to encouraging unlawful sexual activity.
  • The intention of healthcare professionals in providing such advice was decisive; their primary purpose must be to protect the child’s health.

Legal Principles

  • Parental rights over a child are responsibilities exercised for the benefit of the child and are not unqualified.
  • "Gillick competence" sets the standard for a minor’s consent: where a child demonstrates sufficient understanding and intelligence to understand fully what is proposed, they can lawfully give consent to medical treatment.
  • The autonomy of the child in healthcare increases with maturity and capacity, not strictly with age.
  • Medical professionals must assess each minor’s capacity individually and cannot rely solely on chronological age.
  • The scope of "Gillick competence" now applies broadly beyond contraception, including other medical and family law matters.

Conclusion

The House of Lords in Gillick v West Norfolk and Wisbech Area Health Authority established that minors who demonstrate sufficient understanding and intelligence—the threshold of Gillick competence—can consent to their own medical treatment without parental approval, redefining the nature and limits of parental rights and significantly influencing medical and family law in the UK.

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