Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Urgent treatment without available consent
Necessary treatment must not be delayed when a child faces death or serious deterioration and no authorised decision-maker can be reached.
Action: Give immediately necessary treatment in the child's best interests, using the least restrictive effective option and recording urgency, alternatives and senior decision. Continue attempts to identify and contact a person with parental responsibility and involve safeguarding, legal or police support only as the circumstances require. Explain what happened to the child at their level and to the authorised adult as soon as possible, and obtain consent for ongoing non-emergency care.
Synopsis
Obtain valid paediatric consent, assess decision-specific competence, involve children through assent, verify parental responsibility and act lawfully during disagreement, incapacity or emergency.
Consent is a voluntary, informed decision by a person with legal authority and sufficient capacity or competence for that specific decision at that time.
Young people aged 16 and 17 are presumed able to consent to their own medical treatment unless evidence shows they cannot make the particular decision.
A child younger than 16 can consent when Gillick competent: able to understand, retain, use and weigh the relevant information and communicate a choice.
Key red flags
A parent refusing treatment needed to prevent death or serious irreversible harm requires immediate senior, safeguarding and legal escalation; emergency care continues when delay is unsafe.
Investigation priorities
01
First-line: decision-specific capacity or competence assessmentFirst stepFirst line
Identify whether the child or young person can authorise this intervention.
02
First-line: parental-responsibility verificationFirst line
Confirm authority when an adult is asked to consent for the child.
Management branches
Young person aged 16 or 17Presume capacity and support decision
A 16–17-year-old is offered investigation or treatment.
Provide accessible information directly and assess capacity only when there is reason for doubt.
Obtain and document the young person's voluntary decision and invite family involvement with permission when safe.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.