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Gillick competence — DCH MCQ

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ModerateEthics and communicationGillick competenceDCH

A 15-year-old attends alone within the appropriate time window requesting emergency contraception after condom failure. In a private consultation, she demonstrates sufficient understanding of the available options, benefits, risks and consequences. She declines your encouragement to involve a parent or trusted adult. There is no evidence of coercion, exploitation or another safeguarding concern. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Provide emergency contraception confidentially

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as E

The correct answer is A. A young person under 16 who has sufficient understanding and maturity may consent to treatment under the principle of Gillick competence; for contraceptive care, the related Fraser criteria should be considered. Confidential emergency contraception can therefore be provided after confirming informed consent and completing an individual safeguarding assessment. She should be encouraged, but not compelled, to involve a parent or trusted adult. Parental consent or notification is not automatically required, so B and D are inappropriate. Sexual activity below 16 requires careful safeguarding assessment but does not, in the absence of coercion, exploitation or other risk, mandate an automatic police report, excluding C. Emergency contraception is time-sensitive, so delaying care as in E could increase the risk of pregnancy.

Reference: NICE, Contraceptive services for under 25s (PH51), Recommendations: providing contraceptive services to young people, 2014. https://www.nice.org.uk/guidance/ph51/chapter/recommendations