Consent for medical examination and treatment

Follow this procedure to ensure appropriate consent is provided when arranging medical examinations and treatment for children subject to child protection involvement when the child’s carer has not been authorised to make decisions regarding the medical care required.

Introduction

Child protection’s authority to make decisions about health interventions for children with or without parental consent depends upon the legal status of the child. If there is uncertainty, practitioners and managers should consult your local legal representative or the Child Protection Litigation Office (CPLO).

The Secretary’s authority to consent to medical procedures for a child is outlined in s. 597 of the CYFA, ‘Powers of Secretary in relation to medical services and operations’.

During business hours, the Director Child Protection or Assistant Director Child Protection of your division is authorised to consent to medical treatment for a child.

After hours, this delegation is to be exercised by the most senior staff member on shift, which depending on the time will be:

  • Area Manager (CPP 6.1)
  • Practice Manager (CPP 5.2)
  • Team Manager (CPP 5.1 - CPP 5.2)

If a child is placed in out-of-home care through a community service, a senior manager within the community service is authorised to provide consent on behalf of the Secretary. The community service will consult child protection prior to providing consent. See Authorisation for CSOs to provide medical consent - advice for further information.

For some medical procedures the consent of a parent or guardian is not sufficient and a Court order is required. These procedures involve significant, non-reversible effects, for example medical sterilisation. Obtain legal advice if a proposed course of treatment might be in this category.

See Medical and forensic examinations for procedures in the context of investigation or abuse or neglect.

Procedure

Case practitioner tasks

In all cases:

  • Obtain comprehensive information about the recommended medical examination or procedure to inform consultation and decision making.
  • Consult your supervisor and if the child is Aboriginal consult ACSASS.
  • Inform, consult and seek the approval of the child’s parents where possible unless this would be contrary to the child’s best interests.
  • Consult the child to establish if they consent to or refuse the examination or treatment if they have sufficient maturity and understanding of their medical situation and the proposed treatment.

Wherever possible, parents will be informed, consulted and appropriately involved in any medical examination or treatment planned for their child.  Usual practice is to seek parental consent for examination and treatment regardless of whether the legislation requires consent or not. 

 

While a child with sufficient maturity and understanding may provide consent, parental consultation is required if the child is not subject to a care by Secretary or long-term care order (or an order specifying a relevant condition).

For a child in emergency care or subject to an interim accommodation order (IAO)

  • If the child requires an examination to determine their medical, physical, intellectual or mental condition, obtain written approval for the examination from the team manager.
  • If a child who is in emergency care or subject to an IAO:
    • is placed in:
      • an out-of-home care service;
      • a declared hospital;
      • a declared parent and baby unit; or
      • with a suitable person/s; and
    • a registered medical practitioner has advised that medical treatment or a surgical or other operation or admission hospital is necessary to avoid a serious threat to the child’s health; and
    • the child's parent refuses to consent, or cannot be contacted within a reasonable time;
  • obtain written authorisation from the Director, Child Protection or Assistant Director Child Protection to proceed with the recommended treatment. Seek advice from your local legal representative or the CPLO and your supervisor, or during after hours with AHCPES.
  • If a child is placed in care through a community service, contact the community service case manager or placement program to clarify roles, expectations, actions and responsibilities.
  • Consult the team manager and Legal Services if, in the opinion of the recommending doctor, adhering to the child’s stated wishes would pose a significant risk to the child’s health.
  • Make sure that there is a comprehensive record in CRIS, including of the parents’ and child’s views, legal or other consultations, decisions and approvals and the rationales for these.

For a child subject to a family reunification order, care by Secretary order, long-term care order or therapeutic treatment (placement) order:

  • If the child requires an examination to determine their medical, physical, intellectual or mental condition, obtain written approval for the examination from the team manager.
  • If a qualified medical practitioner advises that medical treatment, admission to a hospital, or surgery or other operation is necessary for a child, inform, consult and seek the approval of the child’s parents where possible.
  • If a parent objects to the recommended medical treatment, admission to hospital, or surgery or other operation for a child, obtain written authorisation from the Director Child Protection or Assistant Director Child Protection to proceed with the recommended treatment. Seek advice from your local legal representative or the CPLO and your supervisor, or if after hours with AHCPES.

The authority to consent to recommended medical treatment, hospital admission, surgery or other operation for a child subject to a family reunification, care by Secretary, long-term care or therapeutic treatment (placement) order, even if the the child’s parent objects, is provided for in s. 597(3) of the CYFA and is delegated to executive officer level. Within divisional child protection, only the Director Child Protection or Assistant Director Child Protection can authorise treatment under this section.

  • If a child is placed in care through a community service, contact the community service care manager or placement program to clarify roles, expectations, actions and responsibilities.
  • Consult the team manager and Legal Services if, in the opinion of the recommending doctor, adhering to the child’s stated wishes would pose a significant risk to their health.
  • Make sure that there is a comprehensive record in CRIS, including the parents’ and child’s views, legal or other consultations, decisions and approvals and the rationales for these.

Team manager tasks

  • Review and approve requests for medical examination and treatment and seek further advice and approval as required according to the client’s legal status.

Child protection operations manager tasks

  • Review and approve requests for medical treatment and seek further advice and approval as required according to the client’s legal status.

Supervisor tasks

  • Provide ongoing supervision and support.

Director Child Protection or Assistant Director Child Protection tasks

  • Approve medical treatment even if a parent objects to the proposed treatment, if the registered medical practitioner has advised that the treatment is necessary.
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