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Do Children Have Rights? This article is based on the plight of a 15-year-old girl who was confronted with a heart-rending dilemma. After leading a relatively 'normal' life she finds herself extremely ill and faced with two choices. A heart transplant will save her life. If she does not have the transplant she will die. In this scenario the 15-year-old girl conclusively decides, after careful consideration, that she does not want the transplant. Inevitably her decision means that she will die. There are a number of issues that will be addressed throughout this article all of which will relate to the above scenario. In particular it will discuss the issue of children's rights concentrating on the extent to which children and young people are afforded rights. Also the law will be examined in relation to how children and young people are treated within the legal system. Attention will be paid to the different ways in which children and adults are dealt with under the law. In addition, the way in which the law deals with a young person like the girl in the scenario will be critically examined. Next the ethical dilemma's that the above scenario trigger will be addressed with reference to ethical principles. An attempt will also be made at drawing together the discussions in relation to rights, ethics and the law whilst identifying any relationships that are present. Finally, the concept of empowerment will be discussed in relation to children and the legal realities thereof will be illustrated by reference to the scenario of the 15-year-old girl. All references are in the list below. The first issue to be dealt with is that of children's rights and unfortunately this starting point is far from straightforward. There are rights that everyone enjoys at some stage in their life. However, not all stages of a person's life enjoy the existence of rights. Childhood is a stage when rights are effectively excluded. (Campbell (1992) p 18) When children's rights are discussed it is difficult to state that children are on an equal footing to adults. (Douglas (1992) p 569) Freeman suggests that one must differentiate between four categories of rights when asking whether children possess any rights. These categories include rights to welfare, rights to protection, the right to have the same legal rights that adults enjoy, for example to vote and consume alcohol, and finally the right to act independently. (Freeman 1998/9). Similarly Eekelaar identifies three categories of interests that a child might have, which may form the foundation of a claim or right. Firstly, Eekelaar suggests that children have a basic interest in receiving general physical, emotional and intellectual care. Secondly, children have a developmental interest whereby the child's capacities should be developed and finally, an autonomy interest - the freedom to make choices unhindered by the authority of the adult world. (Eekelaar 1986). What is particularly interesting in both Freeman's and Eeklaar's categories are the issue of children's autonomy, which is a highly controversial area on its own. The idea that children can have and exercise rights, as adults do, is a mere fallacy. Rights do not mean anything unless a person is capable of exercising them. (Heartfield 1993). However, there is a proposition that children and young people are indeed bearers of rights. The United Nations Convention on the Rights of the Child (UNCRC) was drawn up in 1989 and gives children and young people under the age of majority (18) their own 'special set of rights'. (Save the Children (UK) Children's Rights Guide) For example, the UNCRC sets out the minimum standards in relation to children's civil, political, economic, social and cultural rights. Specifically, Article 2 states that the Convention applies to all children without discrimination. Article 3 ensures that the best interests of the child are of primary consideration whereas Article 12 conclusively states that children have a right to express and have their views given due weight according to age and maturity. (Articles 2, 3, 12 UNCRC) Deemed as 'a victory for children's rights' (Wyld (2000) p 17) it is still not possible after 12 years for children and young people to use their national courts to claim their Convention rights. (See Wyld (2000) p 17 and Save the Children (UK) Children's Rights Guide and Morris (1999) p 249) The extent to which children are afforded rights is based on two principles. Both of these are stated in the UNCRC. What is in the 'child's best interests'? What is the age and maturity of the child concerned? In relation to the former principle of the 'child's best interests' its meaning has developed as society has evolved and its interpretation differs on a cultural basis. (Solberg 1997) In European societies children under the age of 16 are classed as 'dependents'. Young people between the ages of 16 - 18 although have some limited rights, especially in the UK, (Section 8 Family Law Reform Act 1969) they are nevertheless classed as 'dependents' and as such it remains unquestioned that the adult understanding of 'a child's best interest' is dominate over what the child may think. (Qvortrup 1997) The 'adult knows best' approach restricts children's freedom and is justified because society views children as irresponsible, lacking capacity and labels children as a social group as incompetent. (Qvortrup 1997 and Freeman (1998/9) p 51) The focus on children is as Freeman and Eekelaar identify - beneficiaries of protection and welfare packages. The second principle depends on the age and maturity of a child. This is based on the concept of competence. Beauchamp and Childress describe competence as 'the ability to perform a task'. (1994, p 134) They go on to say that a child is only competent to make decisions '…if he or she has capacity to understand the material information, to make a judgment about the information in light of his or her values, to intend a certain outcome, and to freely communicate his or her wishes'. (1994, p 5) (Also see Runeson et al (2000) at p 455) It appears that children as a social group have limited rights. Indeed society views children as incapable of exercising rights responsibly until their 18th birthday. When this day arrives society assumes that the irresponsible, incapable and incompetent child becomes a responsible, capable and competent adult who can exercise rights that they were denied the day before. However, it is morally arbitrary and unjust to deny children rights merely because they are younger than adults. In practice it seems that children are denied rights based on a view of socially constructed childhood where children are seen as being in need of protection and are consequently viewed as lacking the necessary capacity required for possessing rights. (Archard (1993) p 59) Bearing this in mind, does the 15 year old in the above scenario have a right to refuse a heart transplant? Based on the age of the girl it is certain that her refusal to consent to the heart transplant is not a right that she possesses. Unlike an adult in the same situation it is the court that will decide whether she is competent to a standard that merits her to exercise any form of autonomy. Purely on the basis of her age and status in society this young person will need to convince a court that she is mature enough to decide what can happen to her body and ultimately her own life. In relation to discussing how the law deals with minors it is necessary to place the child in the appropriate context. In the above scenario the minor is refusing to give her consent to a heart transplant. Whether she has the 'right' to refuse to give her consent, and in turn disagree with a doctor's opinion, rests on the finding as to whether she is competent in law to make such a decision. The consent of a patient to medical treatment per se is essential otherwise there are severe legal consequences. For example, a competent patient who is treated without consent may sue for battery (Re F (Mental Patient: Sterilisation) [1992] 2 AC 1 per Lord Bridge) and the doctor may be found guilty of a criminal offence. (Chatterton v Gerson [1981] QB 432) Therefore, a patient's right to determine what happens to his/her body is viewed as a basic and inviolable human right. (Sidaway v Governors of Bethlem Royal Hospital [1985] 1 All ER 634 per Lord Scarman) English law recognises this right and gives effect to it through the law of consent. (Markesinis and Deakin (1999) p 250) Determining whether a child is competent in law the starting point is the decision in the Gillick case. (Gillick v West Norfolk and Wisbech AHA [1985] 3 All ER 402) The test laid down in this case is that in order for a child to be competent the child must be:
This case is widely regarded as establishing that a child who has reached a sufficient level of intelligence and understanding should be given the right to decide whether to have any proposed treatment. (De Cruz (1999) p 602 and Nathanson (1999) p 12) However, a person aged over 18 years is automatically presumed to have the necessary capacity to consent to medical treatment. (Re JT (Adult: Refusal of Medical Treatment) [1998] 1 FLR 48) The discriminatory nature of the law between adults and children is stark in the area of consent. This is no more apparent when a competent child chooses not to consent to medical treatment but instead decides to refuse to consent to treatment that is deemed by health professionals to be in the 'child's best interests'. In the Gillick case there is no express or implied indication that understanding-based capacity was restricted to consent to, as opposed to refusal of treatment. (Re W (A Minor) (Medical Treatment) [1993] 4 All ER 627 per Balcombe LJ) However, in practice the Gillick decision has been limited to the detriment of competent children. The right to consent to medical treatment should mean that a patient can not only say 'yes' to a course of action, it should also mean that a patient can decline to accept a course of action and equally both decisions should be respected. In relation to consent adults can indeed agree and refuse medical treatment but when it comes children the situation is drastically different. A series of cases have through recent decades made it clear that competent children may agree to medical treatment but cannot refuse to consent to it. (See Re R (A Minor) (Wardship: Medical Treatment) [1991] 4 All ER 402) In effect children assessed as competent are denied the right to express that competence. (Nathanson (1999) p 12) In Re R it was stated that a Gillick competent child's refusal of treatment could be overridden by the court and as Donaldson MR states, those with parental rights or responsibilities could also go against the child's refusal. In addition, if a minor over 16 years refuses to consent to medical treatment the parents are not in the position to override the decision but in Re W ((A Minor) (Medical Treatment) [1992] 4 All ER 627) it was established that the court may override the child's wishes thus placing a child over 16 years in exactly the same position as a Gillick competent child under 16. Controversially the court held that; "…no minor of whatever age has by refusing consent to treatment to override a consent to treatment by someone who has parental responsibility for the minor and a fortiori consent by the court". (Re W (A Minor) (Medical Treatment) [1992] 4 All ER 627 per Lord Donaldson p 639 - 640) In Re R and Re W both children refused to consent to medical treatment and the court took the view that because these children did not agree with the view of the medical profession in relation to the course of action deemed to be in their best interests this was in itself an indication of their lack of competence! (Morris (1999) p 256) Both these cases are evidence of the proposition that the court requires a high level of understanding and appreciation from children to the extent that they are found to be incompetent to refuse life-sustaining treatment. The end result it that in court there is no reason to give independent weight to the child's wishes where these conflict with what is considered to be in their best interests by the medical profession merely challenging the course of action proposed means that the child is incompetent. (Roberts (1999) p 15) The law blatantly discriminates against children. It requires that children, unlike adults, should make wise as well as informed decisions if their choices are to be respected. (Doyal (1990) p 63) A competent adult is entitled to decline medical treatment even life saving treatment. (Airedale NHS Trust v Bland [1983] 1 All ER 821 per Lord Goff) Children cannot. With such discriminatory practice evident in the English legal system it is amazing that there is no evidence to show where the authority is that allows the courts to override refusal of consent by a minor. The whole court system is paternalistic in its approach to children. The question when to give medical treatment to children is probably one of the most sensitive and potentially disputatious dilemma's that raises both legal and ethical issues of great complexity. In relation to professional guidance the ethical considerations of treating children stresses the importance of gaining the co-operation and consent of the child along with that of the parents, acknowledging that any non-consensual treatment is potentially problematic. The fact that children are part of the whole decision-making process as far as medical treatment is concerned involves both irrenconcible and opposing ethical principles. (Morris (1999) p 251) In situations when one is faced with a choice between two equally unwelcome alternatives, which involve a conflict of moral principles, and it is not clear which choice will be the right, then one is faced with an ethical dilemma. (Banks (1995) p 13) Indeed ethical dilemmas frequently arise when one works with children especially those based on children's rights (or lack thereof) and children's welfare. The dilemma in the above scenario is that acting in a competent minor's best interests - performing the heart transplant - means overriding the minor's autonomy. However, if the child's autonomy is respected - and the transplant is not performed - then standing aside means that the minor will be doing something contrary to her interests - she will certainly die. The roots of ethical values come from both consensus in society and religious morals that influence thinking and practice. Ethical values are not enforceable by the law but they are guiding principles that are treated with respect when decision-making is required. (Fletcher and Buka (1999) p 19) The ethical principles involved in the above scenario are undoubtedly medical ethical principles. Gillion (1986) recognises four ethical principles: Autonomy, Beneficence, Non-malfeasance and Justice. Autonomy is where the rights of the individual patient are paramount. This principle encourages individuals to maximise their capacity in order to make their own decisions. Beneficence usually applies to the medical profession itself where medicine is seen for the benefit of patients. The use of medicine does not have to be curative it can also be palliative. Non-malfeasance is correlative to beneficence and is dependent on medical knowledge and procedures. Finally, the ethical principle of justice is based on the way that doctors have to perform the difficult task of resource allocation - How should resources be allocated? What criteria should be implemented? Ethical dilemmas that occur when working with children are due to the tension between autonomy and what is considered to be in the child's best interests from the point of view of the doctor - beneficence. Over recent years there has been a distinct change to an emphasis on the principle of autonomy, which has caused a break down in relationship between autonomy and beneficence. As explained, the principle of autonomy requires one to treat others in a way that allows or enables them to act autonomously. In order to exercise autonomy a person must understand that there is a choice, understand what that choice is and then exercise that choice. (Nathanson (1999) p 12) As Beauchamp and Childress (1994) state: "…the principle of autonomy means that people should not be subjected to controlling restraints by others, as long as their actions do not cause harm to others'. (p 126) To the detriment of beneficence, where the doctor decides what is the best for the patient, patients have now taken it upon themselves to decide, on their own terms, what treatment option they will follow and how it will be followed. (Wilson (1998) p 90) However, when a child is involved the principle of autonomy takes a back seat to the point that this fundamental ethical principle is undermined by what doctors see as the best interests of the child. In essence, children are treated paternalistically because doctors are making decisions for them. There is a stark difference between the way in which adult's and children's autonomy is respected. Minors, unlike adults, are denied the right to make well-informed decisions about their own lives and instead other people's values are imposed on them, disguised as in their best interests. The problem with this ethical dilemma was acknowledged by John Stuart Mill (1974) who said: '…individuals are usually the best judges of what is in their interests and acting on the contrary presumption, that others may know better, is likely to lead to far worse outcomes'. (p 166) When an ethical dilemma arises that involves a minor it is not unusual for the court to determine the outcome. Therefore, it is necessary to consider the relationship between rights, ethics and the law. At a glance it seems as though the court, as courts of law and not morals, deny children rights but this does not mean that the law is ethically right in its determination. When considering the relationship between rights, ethics and law the intricacies of these relationships will be illustrated with reference to the scenario above. The duty of the doctor is to exercise his/her clinical judgment in the context of both ethical and clinical standards considered to be in the best interests of the patient. The duty of the judge is merely to find out the facts of a situation then apply the law and determine the dispute. (Samuels (1999) p 11) If one considers the duties of both the doctor and the judge and then place a child into the equation there is no doubt that the law favours the doctor who is the bearer of fact. Why this happens is due to the way that the law denies the child autonomous rights by falsely finding that the child is incompetent. In a medical setting, that which the minor in the scenario is placed in, in terms of medical ethics, the law has certainly got it wrong. The law undermines basic ethical principles purely on the basis of what judges and doctors see as the best interests of the child. Indeed, there is a legal principle enshrined in countless judicial pronouncements that ultimately the State, by using the courts, may and will intervene to protect children with the paramount consideration being the welfare of that child. (Specific Issue Order. Section 8 Children Act 1989) However, by doing this the law in its paternalistic role is both denying minor's rights and also undermining ethical principles that are automatically respected once the child reaches the age of 18. The conclusion that is not easily reached here is that children either have rights or they do not. The law does not adhere to ethical principles as far as children are concerned. A child's claim to a right is determined on the basis of their competency whereas adults are presumed to be competent and as such their autonomous rights are respected by the law whether the decision made by the adult is in their best interests or not. It is not harsh to say that a minor in the medical context is a legally accepted victim of assault on their body sanctioned by society and justified not on an ethical basis but with reference to the minor victim's long-term welfare. (Roche (1995) p 295) If the law permits such actions against children what can be done so that children, as a social group, can feel in control of their own lives in the face of adversity? Children are 'a voiceless minority with few political or legal rights'. (Lyons and Knight 1995) As a group children exert no influence on any of the powerful groups and institutions which inform and underpin social and economic change. (Martin 2001) Instead children are told, instructed, or ordered to do things that adults and the legal system presume is right or appropriate. They are legitimately forced to abide by the rules, regulations and norms set by adults. As Diressie (2000) states '…worse still, most of the do's and don'ts are not preceded by adequate explanation'. Therefore, what needs to be acknowledged is that children, as future doctors, judges and policy makers, are not only children but they are also apprentice adults who are engaging in an ongoing process of acquiring knowledge and experience of life. (Lyons and Knight 1997) It is with this in mind that empowering children is necessary so as to allow children to make their own decisions within a set structure along with teaching them how to accept the outcomes of their decisions. (Guiteriz 2001) Gomm (1993) describes empowerment as '…helping the less competent to compete more effectively'. (p 136) However, Cullen (1999) states that empowerment is a '…process of trusting, affirming and building self esteem in children'. She goes on to say that empowering children '…should make them feel dignified, confident, affirmed, respected and admired'. Unfortunately, in practice, Cullen's aim of empowering children that she describes is far from been achieved in reality. Empowering children to make their own decisions is, as an advocate, an extremely frustrating role to undertake. Guiding children along the road of paternal authority is difficult to conquer when the legal system treats children as it does. Children lack power because of their 'right to be protected' from others and themselves which arises purely out of the child's 'rightlessness'. (Stainton-Rogers 1989) However, it is not all doom and gloom. Empowering children does indeed make children feel as though they have had their views heard and considered. Furthermore, a part of the empowering process is equipping children to learn how to deal with the outcomes of decisions be it a good outcome for them or one that they consider to be bad. In particular this is important because the legal reality is that the courts attach little weight to the opinions of children but they are not denied their say in court - children are just denied their desired outcome. Children are a social group within our society who are denied rights to a degree that they are marginalized and treated differently to adults. In practice children are seen as incompetent and untrustworthy. They are not allowed to possess the autonomous rights that others enjoy. The law does not respect the child as a social participant in society instead it treats children like a group of incompetents who need protecting awarding them only limited input into what happens in their own lives. It is difficult to understand how the world we live in has some how mysteriously gained authority to treat children as it does. The 15-year-old in the above scenario will have a heart transplant despite her objection. Why will this happen? Because she is viewed in law as not competent enough to make her own decision about her own body. If the child were 18 then her decision to refuse the transplant would be upheld because almost over night she is respected in law. No amount of empowering the child in the scenario will make the outcome any different. You are a child. You will do as I say and not as I do. REFERENCES Banks, S, (1995) Ethics and Values in Social Work, Macmillan Press. Beauchamp, T, and Childress, J, (1994) Principles of Biomedical Ethics, Oxford: Oxford University Press. Campbell, T, (1992) The Rights of the Minor as Person, as Child, as Juvenile, as Future Adult, 6 International Journal of Law and the Family p 1. De Cruz, P, (1999) Adolescent Autonomy, Detention for Medical Treatment and Re C, 62 (4) Modern Law Review pp 595 - 604. Diressie, T, (2000) A Weighty Item on the Agenda of Development, www.archives.geez.org. Douglas, G, (1992) The Retreat From Gillick, 55 (4) Modern Law Review pp 569 - 576. Doyal, L, (1990) Medical Ethics and Moral Indeterminacy, 17 (1) Journal of Law and Society pp 1 - 16. Eekelaar, J, (1986) The Emergence of Children's Rights, 161 Oxford Journal of Legal Studies pp 170 - 171. Fletcher, L, and Buka, P, (1999) A Legal Framework for Caring: An Introduction to Law and Ethics in Health Care, Palgrave. Freeman, M, (1998/9) The Rights and Wrongs of Children, 22 (4) Adoption and Fostering pp 50 - 59. Gillon, R, (1986) Philosophical Medical Ethics, Wiley: Chichester. Gomm, R, (1993) Issues of Power, in Walmsley, J et al, (eds) Health, Welfare and Practice: Reflecting on Roles and Relationships, Milton Keynes, Open University Press. Guiteriez, A, (2001) Empowering Children, www.innerself.com Heartfield, J, (1993) Why Children's Rights are Wrong, www.informinic.co.uk/LM/LM60/LM60_children.htm Lyons, R, and Knight, S, (1997) A Critical Look at Children's Rights, www.generationyouthissues.fsnet.co.uk Markesinis, B, and Deakin, S, (1999) Problems of Medical Law, 4th Ed, Oxford. Martin, F, (2001) The Politics of Children's Rights, Cork University Press. Mill, J.S, (1974) On Liberty, Harmondsworth: Penguin. Morris, A, (1999) Treating Children Properly: Law, Ethics and Practice, 15 (4) Professional Negligence pp 249 - 266. Nathanson, V, (1999) Health and Children's Rights: Inequality, Autonomy and Consent, 161 Childright pp 11 - 13. Qvortrup, J.A, (1997) A Voice for Children in Statistical and Social Accounting: A Plea for Children's Rights to be heard, in James, A, and Prout, A, (eds) Constructing and Reconstructing Childhood: Contemporary Issues in the Sociological Study of Childhood, 2nd Ed, (1997) Routledge. Roberts, M, (1999) R v M Refusal of Medical Treatment, 159 Childright pp 14 - 15. Roche, J, (1995) Children's Rights. In the Name of the Child, 17 (3) Journal of Social Welfare and Family Law pp 281 - 300. Runeson, I, et al, (2000) Children's Consent to Treatment: Using a Scale to Assess Degree of Self-Determination, 26 (5) Paediatric Nursing p 455. Samuels, A, (1999) The Doctor and the Lawyer: Medico-Legal Problems, 67 (1) Medico-Legal Journal pp 11 - 24. Save the Children (UK) Children's Rights Guide, www.savethechildren.org.uk/childrights/rights.html Solberg, A, (1997) Negotiating Childhood: Changing Constructions of Age for Norwegian Children, in James, A, and Prout, A, (eds) Constructing and Reconstructing Childhood: Contemporary Issues in the Sociological Study of Childhood, 2nd Ed, (1997) Routledge. Stainton-Rogers, R, (1989) The Social Construction of Childhood, in Stainton-Rogers, W, et al, (1989) Child Abuse and Neglect: Facing the Challenge, London, Open University Press, pp23 - 29. Wilson, C, (1998) Seeking a Balance: Patient Responsibilities in Institutional Health Care, 5 Medical Law International pp 183 - 195. Wyld, N, (2000) The Human Rights Act and the Law relating to Children, September Legal Action pp 17 - 18. CASES Airedale NHS Trust v Bland [1983] 1 All England Law Reports p 821. Chatterton v Gerson [1981] Queens Bench p 432. Gillick v West Norfolk and Wisbech AHA [1985] 3 All England Law Reports p 402. Re F (Mental Patient: Sterilisation) [1990] 2 Appeal Cases p 1. Re JT (Adult: Refusal of Medical Treatment) [1998] 1 Family Law Reports p 48. Re MB [1997] 8 Medical Law Review p 217. Re R (A Minor) (Wardship: Medical Treatment) [1991] 4 All England Law Reports p 402. Re W (A Minor) (Medical Treatment) [1993] 4 All England Law Reports p 627. Sidaway v Governors of Bethlem Royal Hospital [1985] 1 All England Law Reports p 634. BIBLIOGRAPHY TEXTS Archard, D, Children: Rights & Childhood, (1993) Routledge. Banks, S, Ethics and Values in Social Work, (1995) Macmillan Press. Fletcher, L, and Buka, A Legal Framework for Caring, (1999) Palgrave. James, A, and Prout, A, Constructing and Reconstructing Childhood: Contemporary Issues in the Sociological Study of Childhood, 2nd Ed, (1997) Routledge. Morgan, S, and Righton, P, Child Care: Concerns and Conflicts, (1989) Hodder & Stoughton. ARTICLES Barker, I, R v M Overruling the Wishes of a Child, (1999) 15 (3) Medical Defence Union Journal 4. Brazier, M, and Bridge, C, Coercion or Caring? Analysing Adolescent Autonomy, (1996) 16 (1) Legal Studies 84 - 109. Brown, M, Re W (A Minor) Medical Treatment: Court's Jurisdiction, (1994) 120/121 Law and Justice 55 - 56. Campbell, T, The Rights of the Minor: As Person, as Child, as Juvenile, as Future Adult, (1992) 6 (1) International Journal of Law and the Family 1 - 23. De Cruz, P, Adolescent Autonomy, Detention for Medical Treatment and Re C, (1999) 62 (4) Modern Law Review 595 - 604. Derish, M, and Vanden Heuvel, K, Mature Minors Should Have the Right to Refuse Life Sustaining Medical Treatment, (2000) 28 (2) Journal of Law, Medicine and Ethics 109. Dickey, S, and Deatrick, J, Autonomy and Decision Making for Health Promotion in Adolescence, (2000) 26 (5) Paediatric Nursing 461. Downie, A, Consent to Medical Treatment - Whose View of Welfare?, (1999) 29 Family Law 818 - 821. Doyal, L, Medical Ethics and Moral Indeterminacy, (1990) 17 (1) Journal of Law and Society 1 - 16. Edwards, L, The Right to Consent and the Right to Refuse. More Problems With Minors and Medical Consent, (1993) 1 Judicial Review 52 - 73. Ferguson, A, 'Child M' and her Heart Transplant - A Christian Doctor's Reflections, (2000) 140/141 Law and Justice 22 - 25. Freeman, M, Removing Rights from Adolescents, (1993) 17 (1) Adoption and Fostering 14 - 21. Hamilton, C, and Roberts, M, Tenth Anniversary of the UN Convention, (2000) 30 Family Law 75. Hutchinson, A, Toward a New Legal Ethic, (2000) 150 (6948) New Law Journal 1234 - 1235. James, A, Sociological Perspectives, Family Policy, Family Law and Children: Adult thinking and sociological tinkering, (1999) 21 (2) Journal of Social Welfare and Family Law 23 - 39. Kingscote, G, Child Development, (2000) 14 (42) Lawyer 35. McCafferty, C, Won't Consent? Can't Consent! Refusal of Medical Treatment, (1999) 29 Family Law 335 - 336. Morris, A, Treating Children Properly: Law, Ethics and Practice, (1999) 15 (4) Professional Negligence 249 - 266. Murphy, J, Whither Adolescent Autonomy?, (1992) 6 Journal of Social Welfare and Family Law 529 - 544. Nathanson, V, Health and Children's Rights: Inequality, Autonomy and Consent to Treatment, (1999) 161 Childright 11 - 13. Oates, L, The Court's Role in Decisions About Medical Treatment, (2000) 321 (7271) British Medical Journal 1282. Pywell, S, Should Autonomy or Communitarianism Prevail?, (2000) 4 Medical Law International 223 - 243. Roberts, M, R v M Refusal of Medical Treatment, (1999) 159 Childright 14 - 15. Roche, J, Children's Rights. In the Name of the Child, (1995) 17 (3) Journal of Social Welfare and Family Law 281 - 300. Rukeson, I et al, Children's Consent to Treatment: Using a Scale to Access My Degree of Self-Determination, (2000) 26 (5) Paediatric Nursing 455. Samuels, A, The Doctor and the Lawyer. Medico-legal Problems Today, (1999) 67 (1) Medico-Legal Journal 11 - 24. Whitfield, A, The Meaning of Informed Consent, (1986) 54 (1) Medico-Legal Journal 11 - 25. Wilson, C, Seeking a Balance: Patient Responsibilities in Institutional Health Care, (1998) 3 Medical Law International 183 - 195. Wyld, N, The Human Rights Act and the Law Relating to Children, (2000) Sep Legal Action 17 - 18. INTERNET RESOURCES Cullen, S, Empowering Children, (1999) www.congcreator.com/ifcw99/cullen2.htm, accessed on 26 February 2001. Guiterrez, A, Empowering Children, www.innerself.com/Parenting/Empowering_Children_by_Alina_Guiterrez.htm, accessed on 26 February 2001. Some, S, A Child's Sense of Self, www.innerself.com/Parenting/Childs_self.htm, accessed on 26 February 2001. UN Convention on the Rights of the Child, www.crights.org.uk/law/uncr.html, accessed on 26 February 2001.
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