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Fraser guidelines
The Fraser guidelines are the conditions under which a doctor can give contraceptive advice or treatment to someone under 16 without their parents knowing.
Summary
- Lord Fraser set them out in the 1985 Gillick case in the House of Lords.
- The young person must understand the advice and cannot be persuaded to tell their parents or to let the doctor tell them.
- They must be very likely to begin or continue sex with or without contraception, their health must be likely to suffer without it, and the treatment must be in their best interests.
- They were written for contraception and are now used for other sexual health advice as well. Gillick competence is the wider test of whether a child can consent to any treatment.
In practice
- The background is the criminal law. Under section 9 of the Sexual Offences Act 2003, an adult aged 18 or over who has sexual activity with a child under 16 commits an offence.
- Lord Fraser said his ruling ought not to be regarded as a licence for doctors to disregard parents' wishes whenever they found it convenient.
In Hong Kong
- The Medical Council of Hong Kong's code has no equivalent of the Fraser guidelines and does not mention contraception.
- It says a child who can consent should still be encouraged to involve their parents in important or controversial decisions (section 2.12.3).
- Treatment without the parents' knowledge and consent may be justified in exceptional situations, such as an emergency, neglect, abandonment or when a parent cannot be found (section 2.12.6).
Interview questions
- What are the Fraser guidelines?
- A 15 year old asks for the contraceptive pill and says her partner is 22. What concerns you?
- Why should a doctor encourage a young person to involve their parents?
Sources
- legislation.gov.uklegislation.gov.uk/…/9
- Global Health and Human Rights Databaseglobalhealthrights.org/…/HL-1985-Gillick-v.-West-Norfolk-and-Wisbech-Area-Health-Auth
- Medical Council of Hong Kongmchk.org.hk/…/Code_of_Professional_Conduct_%28English_Version%29_%28Revise
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