MDDUS, the UK-wide dental defence organisation, reminds dentists that, unless in an emergency, only someone with parental responsibility or authorisation from a parent can consent to children not old enough to make decisions about their own care.
Claire Renton, MDDUS dental adviser, says: ‘The issue of who can consent for treatment in children can, in certain situations, be a difficult one to judge and MDDUS advisers have dealt with a number of calls from members seeking advice on this topic.
‘We have encountered cases where a child is brought to the practice by a foster parent or relative and there is uncertainty in determining who holds parental authority to consent.
‘It can be a complex area and, if any doubt exists, we would advise caution and even withholding treatment until evidence is provided in writing of parental consent from a responsible parent. Clearly, withholding treatment would not be appropriate in emergency cases.
‘It is important to remember the basic principle that, generally, only a person with what is known as “parental responsibility” can consent to a child’s dental treatment (assuming the child does not have the capacity to give consent themselves).’
There are many issues to consider when determining parental rights. For example, parents do not lose parental responsibility if they separate or divorce without a further court order on this subject, but they do in cases where the child is given up for adoption. A person also holds parental responsibility if they are the child’s legally appointed guardian or have been granted this right by a court.
‘Dentists should not feel pressurised by social services, foster parents or family members into providing treatment without written evidence of consent,’ says Mrs Renton. ‘It is the right thing to do and protects both dentist and the child.
‘Sometimes parents still retain the rights of the child, even although they are being cared for by someone else. Indeed, sometimes the foster parent or person attending with the child does not know whether or not they have parental responsibility.
‘In cases of marital separation, extra caution is advised when the parent who no longer resides with the child becomes involved in decision-making about their dental treatment. Problems can arise if the resident parent is not kept fully involved and it is recommended to seek advice from MDDUS before proceeding.
‘Furthermore, the dental team should be aware of potential issues regarding parental consent and ensure the child’s details are kept up to date. This also helps avoid any confidentiality breaches.’