House of Lords Rules DHSS Guidance on Contraception Lawful

Abstract

By a 3-2 majority, the House of Lords has ruled that parental rights are not infringed if physicians provide contraceptive advice and treatment to female minors without their parents' knowledge or consent, thereby reversing the Court of Appeal's decision in Gillick v. West Norfolk and Wisbech AHA. Speaking for the majority, Lord Fraser maintained that a doctor would be justified in offering treatment without parental consent when he or she is satisfied that the minor is capable of understanding the advice given, that the minor cannot be persuaded to inform the parents, that sexual activity is likely to begin or to continue, and that the minor's physical or mental health is likely to suffer if contraceptive treatment is denied. Brahams finds the ruling to be pragmatically "sensible" but "inconsistent with the criminal law."The House of Lords has reversed an earlier decision of the Court of Appeals that pronounced the Department of Health and Social Security (DHSS) guideline on family planning services for girls under 16 years of age unlawful. The DHSS guideline permitted girls under age 16 years to receive advice on contraception and termination of pregnancy without parental consent. The appeal focused on 3 strands of argument: 1) if a girl under age 16 years has the legal capacity to give valid consent to contraceptive advice and treatment, 2) if the giving of such advice without parental consent infringes on parents' rights, and 3) if a doctor who gives such advice or treatment to a girl under 16 years without parental consent incurs criminal liability. It was stressed that girls should have sufficient maturity to understand what is involved in contraception and pregnancy termination. The DHSS guideline urges physicians to attempt to persuade young female adolescents to bring their parents into consultation. On the other hand, parental consent or knowledge can be justifiably sidestepped in cases where the girl refuses to involve her parents but is likely to understand the physician's advice and to begin or continue to have sexual intercourse with or without contraception. Age 14-15 years is generally considered the minimum age at which boys and girls have the necessary intelligence and maturity to give valid consent to a medical treatment. This latest decision is expected to please the British Medical Association and family planning clinics.