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The scene
The practice manager of a paediatric dental practice called the DDU for advice about children attending the practice when their parents weren't on good terms, or are separated or divorcing.
A child attended the practice with their father and was advised to have dental treatment. The father consented to the treatment and it was carried out - but later on, the mother called the practice and was angry that she had not been consulted about the treatment of her child.
The practice manager called the DDU to clarify whether they could provide treatment with the consent of only one parent.
DDU advice
Parents might not always be in direct communication and can have different views on the treatment options for their children. This can be difficult for members to manage, and our adviser was able to clarify some key points.
First, it is always important to establish who has parental responsibility and to document this in the patient's record.
When both parents have parental responsibility and the child does not have the capacity to consent, decisions about treatment can be made jointly or individually by the parents. The practice does not need consent from both parents.
The adviser explained that the practice should always work in the best interests of the child. Where parental opinions differ, it may be appropriate to discuss the treatment with both parents - but if one parent does not agree, then the principle of best interests applies. In this case, a second clinical opinion may be useful to support the decision.
The adviser also discussed the concept of Gillick competence and explained that an older child can have the capacity to consent. A capacity assessment should be made, and in situations where a child is Gillick competent, it would be wise to ensure they consent to any of their information being shared with either parent.
The outcome
The practice manager was reassured that they had acted in the best interests of the patient and with parental consent. They were able to update the practice procedure for communicating with separating parents.
Summary
Separation and divorce are often stressful and difficult times for parents and children. It is important that dental professionals do not get drawn into family disputes and continue to act in the best interests of patients.
In many cases, separating parents will want to be informed about the dental care of their children and dental practices can often accommodate this request. Difficulties arise where relationships have broken down to such an extent that communication becomes impossible and where parents disagree over care.
In severe cases, where disagreement could result in neglect, practices should look to their safeguarding procedures and contact the DDU for further advice.
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This page was correct at publication on . Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.