Professor, Faculty of Law, University of Auckland, Auckland, New Zealand.
J Law Med. 2021 Dec;28(4):931-945.
This paper analyses three decisions by different High Courts (England and Wales) concerning the competence of children and adolescents to consent to medical treatment. In Re X (No 2) Munby J upheld two decisions from the early 1990s (Re R and Re W), in which the Court of Appeal held that a court has inherent power to override a Gillick-competent child's refusal of consent to a medical treatment. The second and third decisions concerned puberty blockers (PBs) for gender dysphoria. In Bell, the Full Court considered these "experimental" and "controversial" treatments with potentially lifelong implications, such that it was doubtful that a child under 16 could understand and weigh their long-term risks and consequences and thus be competent to give a legally valid consent to treatment with them. In AB v CD the Court held that parents nevertheless retained the ability to consent to PBs if the child could or did not do so. Bell is subject to appeal. If successful, a court could revisit the interrelationship between the respective legal decision-making powers of Gillick-competent minors, their parents, clinicians, and courts.
这篇论文分析了英格兰和威尔士三个高等法院的三个决定，涉及儿童和青少年同意接受治疗的能力。在 Re X (No 2) 案中，芒比法官维持了上世纪 90 年代早期的两项判决（Re R 和 Re W），上诉法院认为法院拥有固有权力，可以推翻 Gillick 有能力的儿童拒绝同意医疗的决定。第二项和第三项决定涉及性别焦虑症的青春期阻滞剂（PBs）。在 Bell 案中，合议庭考虑了这些具有潜在终身影响的“实验性”和“有争议”的治疗方法，以至于对于 16 岁以下的儿童是否能够理解并权衡其长期风险和后果，并因此有能力合法有效地同意接受这些治疗，这一点值得怀疑。在 AB v CD 案中，法院认为，即使孩子无法或不愿意这样做，父母仍然有权同意使用 PBs。Bell 案可上诉。如果上诉成功，法院可能会重新审视 Gillick 有能力的未成年人、他们的父母、临床医生和法院各自的法律决策权力之间的相互关系。
