Paternity

Request to test male without his knowledge/consent

Tests or checks in respect of a patient can only be carried out with that patient’s consent. Parties subjected to a test on consent do so on the basis of the results being furnished to them. 

Before a GP carries out paternity testing on a minor and the presumed father of the minor the GP should ensure that they have the presumed father’s written consent and the consent of the minor’s mother or legal guardian.

 

Case Studies:

A GP member received paternity test results which proved that a female patient’s male partner was not the father of the child. The female patient did not want the results to be released to her male partner.

Advice:
Parties subjected to a test by consent also do so on the basis of the results being furnished to them. Unless a special arrangement was made with the male partner of the patient, the results of a paternity test affecting the male partner will need to be furnished to him in the ordinary way despite the request from the female partner concerned.

 

Paternal grandparents request for a paternity test:

Advice:
If the father of the child has died, then the child’s mother would be the guardian of the child under normal circumstances and the mother’s consent would be necessary to any examination or test involving the child in question, assuming the child is a minor.

 

Proof of identity – is there a need to produce photo ID: 

GP was taking swabs for a paternity test and the male who presented did not produce photo ID, but only a solicitor’s letter requesting his attendance for testing. It transpired that the man was not in fact the person named in the letter, but in fact the brother of the man named.

A GP must ID the person presenting for paternity testing. In this case GP had noted on the record that the male had no photo ID and therefore the results of the paternity test may be unreliable. A GP could obtain a patient’s documented written consent and take and save, with the relevant records, a photograph of anyone who cannot produce photo ID when presenting for a paternity test.

 

Should a young child be made aware of the nature and purpose of a paternity test?

Medical Council Guidelines

1. Paragraph 18 of the Medical Council Guidelines provides for treatment of children under the age of 18 and states as follows;-

“18.1 When treating children and young people, your primary duty is to act in their best interests. You should involve them as much as possible in discussions about their healthcare, give them information suitable for their age, listen to their views and treat them with respect.

18.2 By law, patients aged 16 years and over are entitled to give consent to surgical, medical or dental treatment. Patients over 18 years are entitled to give consent to psychiatric treatment, organ or tissue donation, or participation in medical research. The law relating to refusal of treatment by young people aged 16 and 17, against medical advice and parental wishes, is uncertain. If this situation arises, you should consider getting legal advice before acting on the decision.

18.3 Where the patient is under the age of 16 years, the parent(s) or guardian(s) will usually be asked to give their consent to medical treatment on the patient’s behalf. “

2. It is generally accepted that children under the age of 16 years should be involved in healthcare decision making but that the decision making rests with the child’s parents, bearing in mind the paramount responsibility to act in the patient’s best interests.

3. The guidelines provide some guidance in relation to conflict between the interest of a parent and child and state at paragraph 18.5 that

If a young person refuses to involve a parent/guardian, you should consider the young person’s rights and best interests, taking into account:

  • the young person’s maturity and ability to understand the information relevant to the decision and to appreciate its potential consequences
  • whether the young person’s views are stable and reflect their core values and beliefs
  • whether the young person’s physical or mental health, or any other factors are affecting their ability to exercise independent judgement
  • the nature, purpose and usefulness of the treatment or social care intervention
  • the risks and benefits involved in the treatment or social care intervention
  • any other specific welfare, protection or public health considerations, covered by relevant guidance and protocols such as the 2011 Children First: National Guidelines for the 


Legislation

1. Section 23 of The Non-Fatal Offences Against the Persons Act 1997 provides for minors aged 16 or 17 to consent to surgical, medical or dental treatment.

 

Case Study

Should a 9 year old be made aware of the nature and purpose of a paternity test?

Advice

You must act in the best interests of your patient.

You will need to consider the age of the particular patient and to consider whether the child is “mature enough to understand the consequences of the test”.

If you do believe that the child is emotionally mature enough to understand the consequences of the test, you must still act in the child’s best interests and consider whether it is in the young child’s best interests to be made aware of the nature and purpose of the test.

You will need to consult with the child’s mother to establish her wishes. If she does not want the child to know and so long as you feel that withholding that information is in the child’s interests, then you should not explain the nature of the test.

If the mother does want the child to know then further consideration will be required;-

  1. There is no absolute answer and the decision will depend on an assessment of the particular case.

  2. For example, if the test establishes that the presumed father is the actual father, it is unlikely to be in the interests of the child to know that paternity was being questioned.

  3. If the test establishes that the presumed father is not the actual father, could the child’s best interest be served by leaving the mother first try to address the issue.

There are no medical or legal guidelines in place for dealing with such situations but for reasons set out above in the discussion, on balance it is more likely that the minor child should not be informed.

 

The contents of this publication are indicative of current developments and contain guidance on general medico legal queries. It does not constitute and should not be relied upon as definitive legal, clinical or other advice and if you have any specific queries, please contact Medisec for advice


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