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Gillick-Competent Teenager Wants Contraception

Ethics · 6 minMMIMedium

Answer the question

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Gillick-Competent Teenager Wants Contraception

A 15-year-old asks you for the contraceptive pill but doesn't want her parents to know. What do you do?

Likely follow-ups
  1. 1What criteria would you apply to assess her competence?
  2. 2What if she were 13?
  3. 3Under what circumstances would you breach confidentiality?

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Resources & frameworks
  • Four pillars: autonomy, beneficence, non-maleficence, justice.
  • Name the conflict → weigh both sides → gather more info → safe, patient-centred action.
What strong answers do
Reveal the benchmark

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  • Reference Gillick competence and Fraser guidelines explicitly. Aged under 16 is not a barrier if she can understand the decision.
  • Note the safeguarding screen: any sign of coercion, age of partner, abuse - shifts the answer.
  • Avoid moralising about contraception itself - the question is about competence and confidentiality, not values.

A worked example: how a strong answer is built

A structure to adapt, not a script to memorise — examiners spot recited answers instantly.

Start from the legal position rather than a personal view: being under 16 does not by itself prevent someone consenting to treatment. The test is Gillick competence — whether this particular young person has sufficient understanding and maturity to understand what is proposed, including the risks, benefits and alternatives. So the first step is to assess her understanding, not to decide whether she should have the pill.

Then apply the Fraser guidelines, which are the specific criteria for contraceptive advice without parental knowledge: that she understands the advice, that you have encouraged her to tell her parents but she will not, that she is likely to continue or begin having sex regardless, that her physical or mental health would suffer without the advice, and that it is in her best interests to provide it. Working through those aloud, in order, is what earns the marks.

Run the safeguarding screen alongside it, because it can override everything above: her partner's age, any sign of coercion, grooming or exploitation, and any concern about capacity. If those flags appear, confidentiality is no longer absolute and the case is escalated through the safeguarding route.

Close on confidentiality itself — that it is the default and that she should be told what would break it and why — rather than on whether teenagers should be having sex. The station is about competence and confidentiality; moralising about contraception is off-topic and is marked as such.

Framework: Gillick competence and the Fraser guidelines, then safeguarding

Mark yourself

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Ethical Awareness

Look for: Correctly applies Fraser/Gillick

0/3

Law Knowledge

Look for: Knows the legal framework

0/3

Empathy

Look for: Patient-centred

0/3

Communication

Look for: Can talk about a sensitive topic

0/3

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Your results

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