SEEING YOUR DOCTOR
Many young people have relationships with their family that encourages or enables discussion about what goes on in their life. That is not universal, however, and the reasons can be many and varied.
Sometimes when beginning to have sexual relationships, it may not be something you want to tell your parent(s). And you may have very valid reasons for this.
In principle, your parents will shape and guide your decision-making while you are under 18, and provide all care that is in your best interests. There tends to be a gradual increase to the responsibility you take for yourself, and parents step back a bit as you grow older.
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Unfortunately, there are a myriad of examples that do not demonstrate this – familial support is not always the guaranteed, and for a variety of reasons.
What does Gillick competence mean?
In medicine, we operate under a legal principle called ‘Gillick competence’. The short version of this is that if a young person is mature enough within themselves to be engaging in more adult decisions, they understand and can communicate the range of consequences from any such decision, they are deemed to be a ‘mature minor’. Practically, this means they have competence to make decisions about their body and their life, particularly where their health care is concerned.
This means that if a young woman has begun to engage in a sexual relationship, for instance, she can see a doctor for any related support. Contraception, including emergency contraception, as well as terminations of pregnancy, counselling in regards to safe sex and relationships, sexual health checks, and supporting with disclosures of sexual abuse or assault are all areas that family doctors, emergency physicians, sexual health practitioners, and other specialist medical practitioners (such as gynaecologists and psychiatrists) can and do assist with.
In practical application, you can see your family doctor or another, independent practitioner for the kinds of things listed above, with a right to confidentiality, and unless you are at risk of harm to yourself or others. That’s because although your privacy is super important, adults (including health care professionals) have a duty to keep you safe.
We’d generally encourage you to involve your parents in that decision making process, but also understand, support and respect you if this is not possible.
If you specifically do not want us to tell anyone, we breach our duty to you in terms of privacy and confidentiality if we do.
In Australia, our legal system is largely shaped by that of England, and so case law provides precedents that guide our own laws. What does that mean?!
If something goes down in the Court system in the UK, the decision made by the judge affects how we do business in Australia.
Legal precedents for young Australian women
With regards to medical decisions for mature minors, a case in the 1980s occurred whereby a young girl under the age of 16 was prescribed contraception by a family planning clinic, without the explicit consent of her mother. Her mother objected and sued the health service on the basis that the provision of contraceptives to her daughter contravened her rights as a parent.
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The court determined that the rights of the parent for underage children was not absolute, and nor do they exist to benefit the parent. The parent’s role, rights and duty is for the benefit and welfare of the child.
It was pointed out that we don’t all suddenly flick a maturity switch on our 18th birthday, and that parents can naturally step back with their decision-making in regards to their children as they grow and gain more maturity.
The principle guiding medical practice in Australia now reflects that, and provision of contraceptives and related advice proceeds on the ‘clinical judgement’ of your treating doctor.
What that means is that your doctor will assess if you have understanding of the consequences of any one decision through uncoerced discussion, to determine if you have capacity or competence to make a specific decision.
In South Australia and New South Wales, specific laws replace the principle of Gillick competence and guide practitioners. In SA, people over the age of 16 can make decisions about their health care, as long as they understand the situation, consequences, decision-making proceeds in their best interests. In NSW, doctors can treat people over the age of 14, although if there is parental objection, there is no protection in law.
The bottom line
As stated above, doctors will generally encourage you to let your parents know what is going on for you, but we acknowledge in some circumstances this may not be possible for you.
If we can’t necessarily help you, we should always provide advice for you to go to someone who can – and you can ask us about this.
REFERENCE LIST
Choahan, N. (2018). Children and consent for medical treatment. https://www1.racgp.org.au/newsgp/professional/what-is-too-young-children-and-consent-for-medical, accessed 11 April 2021.
Gillick v. West Norfolk and Wisbech Area Health Authority (1986). 1 AC 112, [1985] 3 All ER 402, [1985] 3 WLR 830, [1986] 1 FLR 224, [1986] Crim LR 113, 2 BMLR 11 (UK). http://www.hrcr.org/safrica/childrens_rights/Gillick_WestNorfolk.htm, accessed 11 April 2021.