Working with minors in a healthcare setting presents unique legal and ethical challenges. In Australia, health practitioners must navigate various laws, guidelines, and best practices to ensure that treatment is administered appropriately, especially when the client is under 18 years of age.
This blog will provide an in-depth overview of the consent process, the concept of the “mature minor,” working with children checks, confidentiality, and best practice recommendations for healthcare providers.
Understanding Consent to Treatment
In Australia, healthcare practitioners must obtain consent before providing treatment, either expressed (verbal or written) or implied through the patient’s actions.
For informed consent to be legally valid, the individual must understand the risks and benefits of the treatment, make the decision voluntarily, and have the capacity to do so. While these principles are clear for adults, consent for children is more complex.
Who Can Give Consent for a Child?
Generally, parents or legal guardians provide consent for minors. However, under the “mature minor” doctrine, some minors can consent to their own treatment if they show sufficient maturity and understanding.
The “Mature Minor” Doctrine
This legal principle, established in the UK Gillick case and adopted by Australian courts, allows minors who demonstrate maturity to:
- Consent to medical treatment
- Make healthcare decisions
- Authorise sharing of confidential information
- Maintain confidentiality, even from parents
Assessing a “Mature Minor”
Determining if a minor is mature enough to consent requires evaluating their understanding of the treatment, its risks, and their emotional capacity. Practitioners must document their assessment and ensure the minor fully comprehends the decision.
Working with Children Checks
Practitioners working with minors must also be aware of the legal requirements for Working with Children Checks (WWC). These checks are designed to protect children from abuse and are mandatory for anyone providing healthcare or other services to minors in most Australian states and territories.
Here’s an overview of the requirements by jurisdiction:
- ACT: A Working with Vulnerable People check is required and is valid for five years.
- NSW: A Working with Children Check is mandatory and valid for five years.
- NT: An Ochre Card is required for anyone working with children, valid for two years.
- QLD: A Blue Card is required for child-related work, valid for three years.
- SA: A Working with Children Check is required and conducted by the Department of Human Services, valid for five years.
- TAS: A Working with Vulnerable People registration is required, valid for five years.
- VIC: A Working with Children Check is compulsory for anyone working with minors.
- WA: A Working with Children Check is required, which includes a National Police History Check.
Best Practice Recommendations
It is recommended that practitioners obtain the relevant WWC check before treating minors. If a practitioner cannot obtain a WWC check, they should refrain from working with children and avoid allowing unaccompanied minors into their workspace.
Confidentiality of a Minor’s Health Information
Protecting a minor’s health information is vital for healthcare providers. While parents or guardians typically have access to this information, mature minors may request confidentiality. Practitioners must carefully balance the child’s privacy with parental rights, especially in sensitive cases.
Best Practice Recommendations
- Clarify confidentiality: Explain how health information will be handled at the start of treatment.
- Document decisions: Record confidentiality-related decisions, particularly for mature minors.
- Balance sensitivity: Use discretion when handling sensitive information.
Presence of a Responsible Adult During Treatment
Though not legally required, having a responsible adult present during treatment is often advisable, particularly for younger children. For mature minors, this may not always be necessary if they can provide informed consent.
Best Practice Recommendations
- Informed consent: A responsible adult may not be needed if the minor consents.
- Safety first: Ensure an adult is present unless the minor explicitly consents otherwise.
Working with Children and Vulnerable People Checks
Practitioners in South Australia and Tasmania must obtain a Working with Children Check (WWC) or Working with Vulnerable People (WWVP) registration, valid for five years, when working with minors.
Best Practice Recommendations
- Verify requirements: Ensure you have the necessary WWC or WWVP in your region.
- Compliance: Inform responsible adults of your valid checks before treating minors.
Mandatory Reporting of Suspected Child Abuse
Practitioners may be legally required to report suspected child abuse. Laws vary by jurisdiction, making it essential to understand local reporting obligations.
Best Practice Recommendations
- Know the law: Understand and comply with mandatory reporting laws.
- Duty of care: Always act in the best interest of the child, even if reporting isn’t required.
Procedures Performed on Children
Practitioners must consider a child’s developmental stage when selecting treatment techniques. Only use methods proven safe and appropriate for minors within your scope of practice.
Best Practice Recommendations
- Stay within scope: Use only techniques that are safe for children.
- Get trained: Seek further training if unsure about working with children.
Need help understanding your legal obligations when treating minors? Contact us for expert legal advice tailored to your practice.
