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‘This House believes that we have gone too far in granting young people the responsibility for making decisions about their own healthcare’: record of a debate held in the Ethics and Law session of the RCPCH Annual Meeting, York 2009
  1. Vic Larcher1,
  2. Alun Elias Jones2,
  3. Joe Brierley3,
  4. Bharti Mepani4,
  5. Alex Willsher4,
  6. Sarah Linton4,
  7. Courtney Hamilton-Foad4,
  8. Ravi Mistry4,
  9. Haima Raman4,
  10. Hollie Murphy4,
  11. Phillipa Beesley4
  1. 1Clinical Ethics Service, Adolescent Medicine, Great Ormond Street Hospital for Children, London, UK
  2. 2Department of Community Paediatrics, Leicester Primary Care Trust, Leicester, UK
  3. 3Paediatric and Neonatal Intensive Care Unit, Great Ormond Street Hospital for Children, London, UK
  4. 4Royal College of Paediatrics and Child Health, London, UK
  1. Correspondence to Dr Vic Larcher, Department of Adolescent Medicine, Great Ormond Street Hospital for Children, London WC1N 3JH, UK; larchv{at}gosh.nhs.uk

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The age at which children should be allowed to make decisions about their healthcare, and have those decisions honoured, remains controversial. Although some children under 16 years have similar levels of competency to adults, the extent to which they may use this to veto treatments is questionable. It is comparatively rare for young people to debate these issues themselves and have their comments recorded. This paper reports a debate held at the 2009 Royal College of Paediatrics and Child Health (RCPCH) Annual Meeting in York, in which members of the RCPCH Youth Advisory Panel presented arguments for and against the motion that ‘This House believes that we have gone too far in granting young people the responsibility for making decisions about their own healthcare’.

The debate continues to have relevance and topicality and the young people involved marshalled many of the arguments that have been used in a wider context. Developing the latter produced much debate among the young people themselves and resulted in a series of sophisticated, informed and persuasive contributions that facilitated discussion by professionals and parents in the debate itself.

A vote was held before and after the debate and, while the vote was overwhelming in the rejection of the motion on both occasions, a number of individuals changed their views or abstained on the second vote, suggesting that there are more discussions to be had. All those present acknowledged a need for greater dialogue and—irrespective of whether their views should be determinative in all situations—a greater involvement of children and young people in informed healthcare decision-making.

Introduction

The age at which children should be allowed to make significant and wide reaching decisions about their healthcare, and have those decisions honoured, remains controversial. In 1986 the Gillick judgement granted children under the age of 16 the right to …

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