I do not know if you are in England or Wales. The laws differ slightly. If you are 16, you should be able to tell your doctor that you would want to take blood, and ask him to keep this in confidence from your mother. Your mother can refuse that you not take blood, but only when it's not a necessity. At the point where it's a necessity, the doctor should go to the court and ask the court to override your mother's decision. However, as an advanced minor, it looks like you can choose your own life-saving medical treatments. So, you need to pick up the phone, and talk with your doctor. Show him Dr. Whooley's article too. (Brittish courts are less likely to allow advanced minors to refuse life saving medical treatment).
Following is an excerpt from an article by Sarah Whooley in the Brittish Journal of Medicine's June 24, 205 edition. The name of the article is "Jehovah's Witnesses: What are their rights? Children of Jehovah's Witnesses and adolescent." It talks about UK, Canada, and Austalia laws as well. I downloaded it from adc.bmjjournals.com . Below is the excerpt on the UK
Skeeter
**************************below is excerpt on UK laws****************************************
United Kingdom
Well established in British law, is the fundamental principle that every person’s body is inviolate.44
Traditionally, under British law, while regarding the child’s welfare as paramount,
45
courts respect parental wishes concerning children’s medical treatment.
46
Parents have the right
and the duty
to give proxy consent, where required, for a minor.
47
Some arguethat when parents refuse treatment, any procedure is an assault on the child.
48
However, as parental rights and duties are not absolute,
49
existing only for the child’s best interests,
50
the court, ultimately, has overriding control.
45
Established in 1875, 51
he prevailing law in British jurisprudence regarding parental treatment refusal on religious grounds remains unchallenged: parents who fail to obtain medical treatment for their children, are subject to criminal liability even if their refusal is religiously based. In contrast to the USA, there are only three JW cases in the UK contesting the well established legal opinion on parental treatment refusal. In all three cases (
Re O,
52
Re S,
53
Re R
54
), permission for transfusion was granted, confirming the judicial opinion of the US courts: the child’s interests are paramount. The court did stress, however, that although the child’s welfare is paramount, consideration would be given to parental beliefs, particularly when the situation was not imminently life threatening.
. . .
ADOLESCENT JEHOVAH’S WITNESSES
The rights of adolescents to refuse medical treatment vary throughout the world and this judicial inconsistency creates confusion among healthcare workers. In England and Wales, mature minors may consent to, but not refuse, treatment, with the courts using the ‘‘best interests’’ test to override the opinions of adolescents. In Scotland, although the Age of Legal Capacity (Scotland) Act does not specifically refer to treatment refusal, the inference is that a child deemed competent could refuse, as well as consent to, treatment. In North America, the situation for mature minors is state/ province dependent.
United Kingdom
The legal position with regard to mature minors remains ambiguous. In 1969, the Family Law Reform Act
62
set the age of
consent for
medical treatment at 16 but did not specifically deal with parental-child conflict. The implication, however, is
www.archdischild.com
that a child’s consent to a procedure overrides parental opinion. If refusing treatment, however, parents (and indeed the Court) in England and Wales may override the child. In Scotland, this is less likely to happen.In a child under 16, four main issues arise: (1) the child’s capacity to consent to treatment; (2) parental authority and its limitations; (3) whose view prevails when parents andchildren clash; and (4) the extent of the courts’ powers over adolescents.
Gillick v West Norfolk
63
considered the first three issues, with the majority of the House of Lords holding that, if a child under 16 could demonstrate
sufficient understanding
and
intelligence
to understand fully the treatment proposed they could give
their
consent to treatment.
63
If they failed this competency test, parental consent is required. Unfortunately, treatment refusal was not considered. However, this case did specify the limitations of parental rights: ‘‘parental rights are derived from parental duty…exist only so long as they are needed for the protection of…the child’’.
64
The logical inference from
Gillick
63
is that competent children are competent to both accept and refuse treatment; yet subsequent decisions
65 66
suggest that a child’s refusal may be overridden by a proxy’s consent to that treatment and that the child’s refusal, while important, may not be conclusive.
66
Re R
67
sought to clarify a minor’s right to refuse treatment. However, by emphasising that, unlike adults who are presumed competent, minors must prove their competence,
68
and by suggesting that as both parents and children were keyholders to the door of consent,
69
parental consent would be sufficient in circumstances of disagreement, the court undermined the Children Act 1989, which sought to enable mature minors to make medical decisions.
70
Additionally, Lord Donaldson made it clear that the court, in addition to parents, could override a minor’s decision. 71
Essentially this case disempowered minors with regards treatment refusal.
Re W
66
confirmed the courts ability to override parents, children, and doctors when performing its protective functions, but imposed limits on the power to overrule, with the judge stating that this power should only be exercised if ‘‘the child’s welfare is threatened by a serious and imminent riskthat the child will suffer grave and irreversible mental or physical harm’’.
72
All three cases concerning adolescent JWsrefusing blood
73–75
reinforce the decisions made in
Re R 67d
Re W
.
66
The initial test of the ‘‘
Gillick
competence’’ concept came in
Re E
.
74
With parental support, a JW aged 15
L
refused theblood transfusions associated with conventional leukaemia treatment. Court approval was sought to treat him. His parents argued that his wishes should be respected, as he was nearly 16, at which point his consent would be required.
76
In a carefully reasoned judgment, the judge overrode both the child and his parents, deeming the child not ‘‘
Gillick
competent’’.
77
Ward J recognised not only the distinction between knowing the fact of death and fully appreciating the deathprocess, but also the absence of freedom in a teenager
78
‘‘conditioned by the very powerful expressions of faith towhich all members of the creed adhere’’.
74
Confirming wardship and authorising treatment
for the welfare of the child
,
79
he concluded that although parents may martyr themselves, the ‘‘court should be very slow to allow an infant to martyr himself’’.
74
Re S
73
presented the court with a further opportunity to clarify the question of minors and treatment refusal. Influenced by her mother, S had been attending regular JW meetings and decided that she no longer wanted the blood transfusions necessary to treat her thalassaemia major. Court intervention was requested and after careful consideration the judge declared S not ‘‘
Gillick
competent’’.
73
Despite an outward portrayal of confidence,
73
S lacked the maturity of many girls of her age, had led a sheltered life, and showed a lack of understanding about her disease, the mode of death,
80
and the seriousness of her decision (believing in miracles and not understanding that transfusion refusal would certainlyresult in death).
81
The court should therefore authorise treatment
in her best interests.
In
Re L
75
the decision was much easier. The young JW had serious burns and it was impossible to explain to her theseverity of her injuries or the unpleasant nature of her death
75
which would occur without vital blood products. The court deemed her
Gillick
incompetent because, despite the sincerity of her religious beliefs, she was only 14 and had limited life experience.
Logically, the
Gillick
competence concept should ability to both consent to and refusal of treatment. Nevertheless, underEnglish and Welsh law, minors have no absolute right to refuse medical treatment.
82
In the cases described above, the courts concluded that although the minors showed some evidence of maturity and understanding, they lacked sufficient understanding and experience to refuse treatment offering a high probability of success at a relatively low risk.
Where treatment refusal was religion based, there was concern about the child’s freedom of choice in the context of a religious upbringing in addition to concerns about whether the child fully grasped the implications of treatment refusal. Thus, while a child’s refusal should be considered, it is likely that the court will override the refusal in the child’s best interests.
83
Children of Jehovah’s Witnesses and adolescent Jehovah’s Witnesses 717
on 24 June 2005
adc.bmjjournals.com
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