Under Scottish law (Age of Legal Capacity (Scotland) Act 1991 ), children of 16 years of age are considered to have the legal capacity to make decisions, unless they lack the appropriate mental capacity.
However, children of less than 16 years of age can also have the legal capacity to provide consent for their own care if the practitioner believes that the child is capable of understanding the nature and possible consequences of the procedure or treatment. This depends on several things, including the age and maturity of the patient, and the complexity, likely outcome and risks of the proposed intervention.
For a child who is not capable of understanding the nature of the care being provided and its consequences, ask the child’s parent or carer for their consent to proceed.
For a child who is old enough to understand an explanation provided in the absence of a parent or carer, it is advisable that you do not undertake any irreversible treatment, such as an extraction, until parental consent is available. For patients under 12 years it would be unwise to proceed on the consent of the child alone.
If a parent or carer is unavailable you can, under the Children (Scotland) Act 1995 , seek consent for an examination or treatment from a person who has care or control of the child but no parental responsibilities to the child (e.g. step-parent, relative, child minder). This person can give consent if they believe the parent would not refuse consent. Note: this does not include teachers or others caring for a child at school.
If an older child e.g. 15 years, who is able to understand an explanation, refuses parental involvement you can proceed with an examination or treatment but document carefully all discussions. The capacity of the patient to understand the consequences is the most important aspect.
It is important the dental team members are aware of the rights of the child and that the childs’ views are considered, rather than the parent/carer.