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doctors ?

Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
i've been selfharming on and off for the past nine years, but over the last three or so, it's gotten pretty serious. i cut pretty deeply, and pretty regularly, and im begining to loose sensation in my hands, and finding it hard to move them. i think this might be because of the cutting ?

anyway, im fifteen and live in scotland, and im finding it really hard to find out about confidentialiy laws in scotland. i know that in schools, if you're under sixteen then they have to contact your parents, but i wasnt sure what the laws concerning gp's are. so any help with that would be great.

also, what can i expect if i decide to go to my gp ? having not been to a doctor since i was about six, im absolutely crapping my pants, especially as i have a real phobia about doctors and hospitals. does anyone have experience of gp's ?

thankyou,
lauren.

Comments

  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Hi Lauren,

    First off I think it's really positive that you're considering going to your GP about your self harm. Although I'm not sure how variable the confidentiality laws are between Scotland and England I have found the following link: http://www.hris.org.uk/index.aspx?o=1027#6 which includes some information on confidentiality in Scotland. Although it doesn't go into much detail about under 16s it does state that parents will be informed if the GP believes that the patient does not fully understand the treatment being offered, e.g. medication/counselling. However, as you are 15 and seeking treatment yourself I would assume in your case your GP would feel no need to tell anyone else.

    If you are still worried it might be worth going down to your GP surgery and asking for a copy of their confidentiality agreement before you make any appointment. Most cases when confidentiality needs to be broken will be done ideally with the patient's consent and you would not be unaware that anyone else would be told.

    In answer to your second question about what to expect, it does vary from practice to practice but generally a medical history will be taken - so the doctor will ask if you know of any other people in your family who have had problems with self harm, etc. The doctor may ask to see your self harm in order to ascertain the severity of the cuts, etc and discuss how you treat your cuts after self harming. He or she may also do a general health check to see if anything else has been affected by your self harm (in this case your loss of feeling in your arms)

    In terms of treatment there are numerous things your doctor could suggest and these are many, but include: referral to counselling, pyschotherapy, talking therapy, prescription for anti depressants, etc. It could be one, many or none of these, but you should ask any questions with the doctor if you feel like you do not fully understand why he or she is suggesting something.

    If you are worried about being treated negatively by the doctor for your self harm (I'm not sure if you were by your original post) you have every right to go and see a different GP in the practice (you can also request this when you make an appointment if you would feel more comfortable talking to a male or female doctor). Most health care professionals are very clued up about mental health problems and you should not be expected to be treated negatively by a GP.

    Hope this helps - and again, well done on seeking help.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    cheers for the help. :) and yeah, im also worried about incase th doctor reacts negatively. but if that happens, i can sort something out. thanks for the link, its a great help.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    No problems. Hope it goes ok. If you're still worried have a think about taking a close friend with you for support - even if just to sit in the waiting room.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Under section 2(4) of the Age of Legal Capacity (Scotland) Act 1991 a person below the age of sixteen has the capacity to consent to any surgical, medical or dental procedure or treatment where the qualified practitioner attending him or her is of the opinion that the young person understands the nature and possible consequences of the procedure or treatment.

    Essentially what this means is that if the doctor believes you are sufficiently mature enough to understand the treatment options and what the consequences of accepting or refusing a particular treatment option then you have the right to make the decision yourself.

    Once you have, in the opinion of the doctor, achieved this point the patrental rights and parental responsibilities that your parent or legal guardian has in relation to your healthcare cease. Therefore you are entitled to confidentiality as if you were over 16. This again is covered by the Age of Legal Capacity (Scotland) Act 1991
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Avizandum wrote: »
    Under section 2(4) of the Age of Legal Capacity (Scotland) Act 1991 a person below the age of sixteen has the capacity to consent to any surgical, medical or dental procedure or treatment where the qualified practitioner attending him or her is of the opinion that the young person understands the nature and possible consequences of the procedure or treatment.

    Essentially what this means is that if the doctor believes you are sufficiently mature enough to understand the treatment options and what the consequences of accepting or refusing a particular treatment option then you have the right to make the decision yourself.

    Once you have, in the opinion of the doctor, achieved this point the patrental rights and parental responsibilities that your parent or legal guardian has in relation to your healthcare cease. Therefore you are entitled to confidentiality as if you were over 16. This again is covered by the Age of Legal Capacity (Scotland) Act 1991

    thats really helpful :) thankyou.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Avizandum wrote: »
    Essentially what this means is that if the doctor believes you are sufficiently mature enough to understand the treatment options and what the consequences of accepting or refusing a particular treatment option then you have the right to make the decision yourself.

    Yep that's true, although it will only work if you're just under 16, if you were 13 for example there is no way any doctor no matter how mature you appear to be during the consultation would allow you to. If you're 15 though you should be ok
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Blacksheep wrote: »
    Yep that's true, although it will only work if you're just under 16, if you were 13 for example there is no way any doctor no matter how mature you appear to be during the consultation would allow you to. If you're 15 though you should be ok

    That is simply not true. The Act is very clear. Parental rights and responsbilities cease when, in the view of the registered practitioner, the child has sufficient maturity to understand the nature and possible consequences of the procedure or treatment. End of.

    If a Doctor (or any other registered medical practitioner) was to go ahead and breach confidentiality where a child was of sufficient maturity outside of the normal guidelines for breaching the confidentiality of an adult they would be in breach of not only the law, but the standards they must adhere to as set down by their professional body. Ultimatley it could cost them their career.

    We've seen children as young as 13 having abortions without parental knowledege or consent because they have, in the view of the practitioners attending to them, met the test set out under section 2(4) of the Age of Legal Capacity (Scotland) Act 1991

    Stick to the facts and don't give your opinion.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Avizandum wrote: »
    Parental rights and responsbilities cease when, in the view of the registered practitioner, the child has sufficient maturity to understand the nature and possible consequences of the procedure or treatment. End of.

    so i should be okay to go ? im pretty mature, atleast i like to think so.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Avizandum wrote: »
    Stick to the facts and don't give your opinion.

    Does "Gillick" apply in Scotland as well then?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    so i should be okay to go ? im pretty mature, atleast i like to think so.

    It's up to the doctor to decide if you're of sufficient maturity. When you go just state at the start of the consultation that you don't want your parent's to know and it's up to the doctor to do the rest.
    Does "Gillick" apply in Scotland as well then?

    The Gillick Competency doesn't apply. Section 2(4) of the Legal Capacity (Scotland) Act 1991 essentially has the same effect, but is a statutory provision rather than a common law principle
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    So it's Gillick but enshrined in law. Good move.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Avizandum wrote: »
    Stick to the facts and don't give your opinion.
    If YOU are telling people by quoting bits of the law at them, that they can go into a GP surgery however young they are and as long as they act grown up no-one will break confidentiality you're very much mistaken. Most GPs as I said would not ever consider a 13 year old or younger to be mature enough to make certain decisions on their own. That is fact.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Blacksheep wrote: »
    If YOU are telling people by quoting bits of the law at them, that they can go into a GP surgery however young they are and as long as they act grown up no-one will break confidentiality you're very much mistaken. Most GPs as I said would not ever consider a 13 year old or younger to be mature enough to make certain decisions on their own. That is fact.

    That is NOT a fact. it's merely your opinion as you've nothing to back it up with.

    With Children as young as 12 being able to have abortions (amongst other things) quite legally without parental consent or parental knowledge then this clearly backs up the point that GPs can and do consider children that young to be mature enough to understand the nature and possible consequences of the procedure or treatment.

    In Scotland the Law assumes that from the age of 12 a person can make their own decisions about their health care information unless there is evidence to suggest they can’t. So, this would allow a child of 12-16 to prevent their parent's from accessing all or part of their medical records.

    Furthermore in Scotland, a person can at any age consult a doctor for advice or support about any issue in complete confidence. Of course, issues arise where the advice sought relates to potential abuse of a child, and under confidentiality rules and guidance on such matters would be disclosed to the appropriate authority (i.e. Social Services). The test set out under section 2(4) of the Age of Legal Capacity (Scotland) Act 1991 applies when treatment becomes an issue.

    The test must be applied objectively and not subjectively. It is not there to be applied at the whim of a doctor for a child of 12 years and above has the right to instruct solicitors and raise proceedings in court and this places them in a powerful position. A doctor must be able to demonstrate why they felt the child was not of sufficient maturity to consent to medical treatment or procedures otherwise they risk their career. It's a tough decision and not one that I would like to make myself because get it wrong in either case (i.e. maintain confidentiality inappropriately or fail to maintain confidentiality inappropriately) and ultimately the medical professional (doctor, nurse, physio, dentist etc.) can lose their registration and thus their right to work.

    You may want to read the leaflet here. This leaflet is produced by NHS Scotland and provides information on confidentiality for under 16s in Scotland.

    Also the following is taken from the Scottish Child Law Centre:
    You can see a doctor at any age but the doctor will only give you treatment if the doctor thinks you understand enough about it. If the doctor thinks that you do understand enough to make your own decision about your treatment then they cannot tell anyone else about it without your permission. So they will not phone your parents or carers, or mention anything about it without asking you first.
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