GP avoids prosecution over circumcision of 3 month old babyBMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5297 (Published 14 November 2017) Cite this as: BMJ 2017;359:j5297
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The alleged malpractice is consistent with case law on circumcision and consent.
In general, for most medical procedures on minors who are too young to have capacity to consent, the consent of any one party with parental responsibility is sufficient. A case heard at the court of appeal in 1999, however, found that circumcision was a "controversial procedure", and should be treated as an exception to the normal rule, and should not be carried out without either the consent of all who hold parental responsibility or a Specific Issue Order: "The decision to circumcise a child on ground other than medical necessity is a very important one; the operation is irreversible, and should only be carried out where the parents together approve of it or, in the absence of parental agreement, where a court decides that the operation is in the best interests of the child."
Sadly, at the height of the MMR scare in the early 2000s, similar case law was applied to MMR vaccination. At that point - as the result of Wakefield's allegedly fraudulent claims and an ignorant media firestorm - this was viewed by the court as a "controversial" procedure. As a consequence vaccination remains a "controversial" procedure, which can only be done with the consent of all persons with parental responsibility.
In practice, advice to practitioners is that if it is known that one parent objects, vaccination can only proceed if that person changes their mind or if there is a court order; but that vaccination should proceed if one parent consents UNLESS there is reason to believe that another parent objects (such as that they have previously informed the practice to this effect).
It is high time this rule was overturned. Cases continue to arise - often following parental separations in which one or both parents use the child or children as a weapon to hurt the other parent - in which a court order is required; and in every case that I am aware of or have been involved in the court has agreed that the child's best interests are served by vaccination. But these decisions are usually made in lower courts, which do not set case-law, and so cannot overturn the precedent set by Sumner.
1. Butler-Sloss E, Schiemann, Thorpe. In the matter of Re J (child). In: England and Wales Court of Appeal (Civil Division), editor: BAILI, 1999(http://www.bailii.org/cgi-bin/markup.cgi?doc=/ew/cases/EWCA/Civ/1999/302...).
2. Sumner. A & D v B & E. In: England and Wales High Court (Family Division) Decisions, editor: BAILI, 2003 (http://www.bailii.org/ew/cases/EWHC/Fam/2003/1376.html).
Competing interests: No competing interests