A rock and a hard place? Ministry of Defence | Defence News | MOD confirms loss of recruitment data

[James Cox]

On 18 Feb 2008, at 21:15, Ian Batten wrote:

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

>> of the NHS, so please help me - how could a 6 year old give =20
>> informed consent to a valve replacement? An 8 year old to a bone =20
>> marrow transplant? The only time that parents don't have immediate =20=

>> carte blanch=E9
>
> is when they propose to have a stomach biopsy carried out to look =20
> speculatively for indications of whatever it was that Wakefield said =20=

> caused autism.

yes- clinical value is an important part of the equation, and applies =20=

equally to both adults and children (though weighs a little heavier =20
for kids).

> And the existence of Munchausen's by Proxy implies lack of carte =20
> blanche.

Munchausens is a mental illness and therefore neglect; social services =20=

would probably step in at this point, if everything was appropriately =20=

joined up. (as i mentioned).

>  And the row about hysterectomy in handicapped children.

yes. that one is tricky. that's more of an ethical consideration. That =20=

it's a child adds complexity, certainly - however many adults are also =20=

not deemably Gillick Competent either.

> And I can't get depot provera for my daughters on my say-so, either.

I would hope not.... but again the Fraiser Guidelines have paved the =20
way for this too....

Again, i emphasise- there are always edge cases - to steal a computing =20=

term - but for the majority of parents with the majority of kids with =20=

the majority of procedures, the parents have the say-so and that's that.

Now, if you _really_ wanted to stymy my argument, you should start =20
talking about divorced parents with shared (or, worse, unclear) =20
custody..... :D

--james=20=