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Safeguards for young minds: young people and protective legislation, 2nd edn
  1. Q Spender

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    Edited by Richard White, Anthony Harbour, Richard Williams. Gaskell (The Royal College of Psychiatrists), 2004, £15.00, pp 118. ISBN 1 904671 02 0

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    This book is invaluable for child psychiatrists, but not all paediatricians would be so attracted to it, except those who wish to understand the legal basis of child protection work. Those who might see it as irrelevant would be missing out on the combined rich experience of two paediatric solicitors and one child psychiatrist.

    The chapter on consent is essential for all clinicians dealing with children, and has a superbly helpful flow diagram detailing how and when the child, young person, or parents can agree or refuse to medical or psychiatric assessment or treatment. The rules governing consent and refusal are surprisingly different. To my consternation, it leaves out all mention of assent, which I understand is a young person’s agreement to something that is legally sanctioned by others, and which I think is increasingly being sought in written form.

    The best advice in the book is contained in one of the prefatory pages—consult a solicitor whenever in doubt. Don’t leave it until the issue is so contentious as to need deciding by the Courts. If you can develop a relationship with a legal adviser, this, the authors say, will be more valuable than any book. Although this may appear to be a free advert for solicitors, it is sound advice: your professional indemnity association and your Trust’s solicitors should already be paid for.

    This is the second edition of a 1996 book that expanded on the authors’ condensation (in previous writings) of The Children Act 1989 to include related legislation. The new edition includes explanations for professionals dealing with children of The Human Rights Act 1998, The Children (Leaving Care) Act 2000, and The Mental Health Act 1983, revised in 1998 by a new Code of Practice. It will need further updating when and if the intended new Mental Health Act becomes law. The authors tread with great clarity through the confusing overlap of the Children Act and the existing Mental Health Act—which should be clarified by the new Act. They cover what you can and can’t do to children in hospital, and how age and the Gillick principle should affect clinicians’ decisions.

    The book is written in commendably clear language, with a layout that encourages selective reading. If it has a significant fault, it is the lack of clinical details to flesh out the plentiful legal cases. It may seem to some like a primer for students of law, but it is in fact intended for, and essential for, practising clinicians.

    Every department of child health should have a copy of this book, as well as every CAMHS service.

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