The Children Act by Ian McEwan Page B

confirmed that Adam had only the vaguest notion of what would happen if he did not receive blood. He had a general, somewhat romantic idea of the death that awaited him. Therefore he could not be said to fulfill the terms as set out by Lord Scarman. Adam most certainly did not “understand fully what is proposed.” Quite rightly, the medical staff wouldnot want to explain it to him. The senior health professional was in the best position to judge, and his conclusion was clear. Adam was not Gillick competent. Second, even if he was, and therefore had the right to assent to treatment, this was very different from the right to refuse life-saving treatment. On this the law was clear. He had no autonomy in the matter until he was eighteen.
    Third, it was plain, Berner continued, that the risks of infection following transfusion were minimal. Whereas the consequences of not transfusing were certain and horrific, probably fatal. And fourth, it was no coincidence that Adam happened to have the same particular faith as his parents. He was a loving and devoted son who had grown up in the atmosphere of their sincere and strongly held beliefs. His highly unconventional views concerning blood products, as the doctor had forcefully suggested, were not his own. All of us, surely, had beliefs at the age of seventeen that would embarrass us now.
    Berner summarized at speed. Adam was not eighteen, did not understand the ordeal that lay ahead of him if he was not transfused, had been unduly influenced by the particular sect he had grown up in and was aware of the negative consequences should he defect. The views of Jehovah’s Witnesses lay far outside those of a modern, reasonable parent.
    As Mark Berner turned to sit down, Leslie Grieve was already on his feet. In his opening remarks, which he addressed a few feet to Fiona’s left, he too wished to direct her attentionto a pronouncement of Lord Scarman’s. “The existence of the patient’s right to make his own decision may be seen as a basic human right, protected by the common law.” This court should therefore be extremely reluctant to interfere in a decision regarding medical treatment made by a person of evident intelligence and insight. It was plainly not enough to take shelter behind the two or three months that separated Adam from his eighteenth birthday. In a matter so gravely affecting an individual’s basic human right, it was inappropriate to resort to number magic. This patient, who had repeatedly and consistently made his wishes clear, was far, far closer to being an eighteen-year-old than he was to being seventeen.
    In an effort of memory, Grieve closed his eyes and quoted from Section 8 of the Family Law Reform Act of 1969. “The consent of a minor who has attained the age of sixteen years to any surgical, medical or dental treatment which, in the absence of consent, would constitute a trespass to his person, shall be as effective as it would be if he were of full age.”
    All those who met him, Grieve said, were struck by Adam’s precocity and maturity. “My Lady would be interested to know that he has read aloud some of his poems to the nursing staff. To great effect.” He was far more thoughtful than most seventeen-year-olds. It was necessary for the court to have regard to the position had he been born a few months earlier, when his fundamental right would have been secure. With the full support of his loving parents, he had made clear his objectionto treatment and he had articulated in detail the religious principles on which his refusal rested.
    Grieve paused, as if to reflect, then gestured toward the door through which the consultant had exited the courtroom. It was perfectly understandable for Mr. Carter to despise the idea of withholding treatment. This merely demonstrated the professional devotion one would expect of so eminent a figure. But his professionalism clouded his judgment as to Adam’s Gillick competence. Ultimately, this matter was not