Angela Harkins investigates the issue of consent in blended families.

Blended families are a common part of modern family life, with step-parents often living and looking after the children of their spouse or civil partner. However, despite this, step-parents and parents are often unaware of the legal implications of these relationships.

What is parental responsibility?

Legally, parental responsibility is a very important concept between parents and children. It is defined by The Children Act 1989 as ‘all the rights, duties, powers, responsibility and authority’, which by law a parent has in relation to their child. This includes:

  • The right to give consent to medical treatment
  • Statutory right to apply for access to the health records of their child
  • The freedom to delegate some decision-making responsibility to others.

A mother will automatically have parental responsibility for her child. In Scotland, a father has parental responsibility if he’s married to the mother when the child is conceived, or marries her at any point afterwards. An unmarried father has parental responsibility if he’s named on the child’s birth certificate after 4 May 2006. It is also possible to apply for parental responsibility.

Individuals do not automatically obtain parental responsibility for a child by marrying or entering into a civil partnership with the child’s parent. Since 30 December 2005, a step-parent who is married to, or the civil partner of, a parent who has parental responsibility for their child may apply for an order for parental responsibility.

The principles of informed consent

Usually, only one person with parental responsibility is required to authorise a child’s treatment. In principle three: obtaining valid consent, the GDC states that it is the responsibility of the dentist to ‘provide patients with sufficient information and give them a reasonable amount of time to consider that information in order to make a decision.’

This means explaining to patients or, in the case of young children, to someone with parental responsibility, in non-technical language the nature, purpose and risks of the proposed procedure and any alternatives. If the treatment is difficult to understand, you can consider using drawings, diagrams and models.

Child is accompanied by another family member or a childminder

If you’re unable to contact a person with legal parental responsibility, your overriding consideration should be the best interests of the child. Consider the nature and possible risks of the proposed treatment, the consequences to the child if untreated and the urgency.

If a child is in pain and a temporary solution isn’t possible, don’t delay emergency treatment that is in their best interests. Whatever your decision, note the details of any discussion in the patient’s records. Include details of who the discussions were with. It can be helpful to consider getting a second opinion.

Step-parent wants access to their child’s records

When a step-parent requests access to a child’s records it’s important to establish if they have parental responsibility.

If the child is over 16 or capable of understanding the significance of disclosure of their records, you should respect their confidentiality and only disclose records with their consent.

However, if the child lacks capacity to make the decision and you believe it’s in their best interests, you can allow someone with legal parental responsibility to access a child’s records. If you’re in doubt about the person’s status, you could ask to see a copy of the child’s birth certificate and/or the parents’ marriage certificate, or a letter from the person’s solicitor.

There’s no obligation to seek consent from the other parent but it may be wise to make sure they’re aware of the request and that you consider any objection they may make.

This is a sensitive area and can initiate issues of confidentiality and consent so if in in doubt contact your defence organisation for advice.

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