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[James Cox]

On 18 Feb 2008, at 16:00, Dr Adrian Midgley (In the office) wrote:

> James Cox wrote:
>
>> Parents typically get carte blanche to decide what treatments their =20=

>> kid has
>
> No.

I know you sign your emails Dr, and you seem to show some knowledge of =20=

the NHS, so please help me - how could a 6 year old give informed =20
consent to a valve replacement? An 8 year old to a bone marrow =20
transplant? The only time that parents don't have immediate carte =20
blanch=E9 is in the case of suspected neglect (intentional or otherwise) =
=20
or that the child themselves expresses a wish to provide consent and =20
manages to convince everyone they aren't stupid.
>
>> Interestingly, this all has presented significant challenges to the =20=

>> patient care record system implementors- i don't believe they found =20=

>> a reasonable solution for managing such access in a safe way.
>
> You are correct.  The sealed envelope, whcih does not AFAIK exist, =20
> is not such a solution.
>
> GPs OTOH are quite good at it, as are their staff in general.

Given a GP's staff doesn't (afaik) sign the oath of secrecy, yet they =20=

do lots of transcription and are familiar with the health issues of =20
_local_ people, i'd generally think that it's an insecure and unsafe =20
system myself.

-james=