People who have parental responsibility are entitled to provide consent for medical treatment for their children. In most cases, parents make the decision jointly, or they are in agreement regarding the child’s treatment. But sometimes, they disagree. This article deals with the situation when you can’t agree with your ex over your child’s medical care.
People who have parental responsibility are entitled to provide consent for medical treatment for their children. In most cases, parents make the decision jointly, or they are in agreement regarding the child’s treatment. But sometimes, they disagree. This article deals with the situation when you can’t agree with your ex over your child’s medical care.
What happens when those with parental responsibility disagree about treatment?
The law only requires one parent to agree in order for doctors to provide medical treatment lawfully to a child. Parents can disagree, and this leaves doctors in an unenviable position because they are reluctant to override a parent’s strongly held views. This is particularly true where the benefits and burdens of treatment are finely balanced, and it is unclear what is in the best interest of the child.
Parental disputes over treatment can be difficult for all those involved, and health professionals must ensure they avoid being drawn into family melodrama and martial disputes and only concern themselves with the welfare of the child.
Doctors will always try to reach a consensus with the parents over a child’s treatment, but if all discussion fails, they will ultimately decide whether to go ahead. The onus will then be on the dissenting parent to take steps to reverse the doctor’s decision. If the dispute is over an ‘elective’ procedure, such as male circumcision for religious purposes, doctors cannot proceed without a court order saying they may do so.
In cases concerning older children, if they are considered competent and understand the issues, their consent will be sufficient for treatment to go ahead. Although, with the child’s agreement, doctors will always try to involve parents in any decisions.
When is a child considered competent and does this limit parental responsibility?
It has been mentioned above that a young person may be able to make a decision about their own treatment. Although there is no statutory guidance on this issue for children under the age of 16, the landmark Gillick case held that “parental rights were recognised by the law only as long as they were needed for the protection of the child and such rights yielded to the child’s rights to make their own decisions when he reached a sufficient understanding and intelligence to be capable of making up his own mind”. That said, subsequent cases have retreated from this position where treatment has revolved around refusal of care.
For medical treatment that is unlikely to have serious consequences, consent from a young person under 16 will be taken into account, providing they can demonstrate they have a level of comprehension that understands the nature, purpose, and possible consequences of the care they are receiving.
Can a relative other than a parent give consent to medical treatment?
Apart from those with parental responsibility, any person who cares for a child, for example, a grandparent or child minder is legally allowed to do “what is reasonable in all the circumstances of the case for the purpose of safeguarding or promoting the child’s welfare”. Parents can also authorise a third party to take over certain responsibilities. This could be because the parents have arranged for someone else to look after the child while they are away, for example. That said, it is unlikely to be considered “reasonable” under the Children Act, for a non-parent to provide consent if they knew the child’s parents would object.
Are there limits to parental responsibility and medical treatment?
There are limits on what parents can decide in respect of their child’s medical treatment. They are not entitled to inappropriate treatment or to refuse any treatment that is in the child’s best interests. Where doctors believe parental decisions are not in the child’s best interests, they can challenge it in the court. During this time, doctors can only provide emergency treatment essential to preserving life or preventing serious deterioration in the child’s condition.
Why disputes over medical care occur
Most co-parents reach agreement on routine medical issues, such as visiting a GP, attending dentist appointments or dealing with short-term illnesses. However, disputes are more likely when:
- Choices involve long-term treatment — such as prolonged medication for ADHD or asthma.
- Treatments are controversial or perceived as risky — for example, immunisations, hormone therapies, or cosmetic procedures.
- Parents have different beliefs about health and wellbeing — one parent may favour conventional treatment, the other complementary therapies.
- Communication has broken down and cooperation is poor.
A disagreement may also originate from conflicting advice given by medical professionals, particularly where symptoms are ambiguous or clinical evidence is not definitive.
Legal tools available to resolve disputes
Specific Issue Orders
When parents cannot resolve a disagreement, the most common legal remedy is a Specific Issue Order under section 8 of the Children Act 1989. This asks the court to decide who makes the decision, or what the decision should be, in relation to a particular issue, such as medical treatment.
For example, one parent may seek a Specific Issue Order directing that a child receive a particular course of treatment, while the other opposes it on grounds of risk, upbringing beliefs, or concern about side-effects.
A Specific Issue Order can:
- Specify the treatment that should take place
- Decide which parent should make the decision
- Restrict a parent from consenting to treatment that has been deemed not in the child’s best interests
Applications for these orders usually begin with a Mediation Information and Assessment Meeting (MIAM) to explore whether dispute resolution is possible without court intervention, unless urgent issues make this unsuitable.
Prohibited Steps Orders
Where the concern is that a parent might unilaterally take certain action, for example, remove the child from the country for treatment, a Prohibited Steps Order can be sought. This stops a parent from taking a specific action without the court’s consent.
This type of order is particularly useful in cases where one parent fears that the other might act without consent in a way that could harm the child or disrupt legal arrangements.
Vaccine disagreement
Consider the common scenario where separated parents disagree over childhood immunisations, a topic that has become increasingly contentious in recent years.
A father may wish to follow the national vaccination schedule, supported by medical evidence showing protection against serious diseases. The mother, however, may resist based on misinformation or personal beliefs.
In such cases, courts tend to favour evidence-based medical advice, and Specific Issue Orders authorising standard immunisations have become the norm where refusal is not backed by credible clinical rationale. Based on how cases are typically decided, the welfare of the child (including protection from communicable diseases) outweighs philosophical objections. Judges will rarely allow a parent to withhold recommended vaccines where serious risk has been demonstrated by medical experts.
Mental health treatment
Another type of common dispute surrounds mental health interventions, such as counselling or medication for anxiety, ADHD, or depression. These disagreements may reflect differing perceptions of mental health care rather than outright refusal of necessary treatment.
For instance, one parent may believe that psychological therapy will support the child’s emotional resilience. While the other fears labelling or adverse effects from long-term medication.
In these scenarios, courts look for evidence of clinical need backed by professionals like psychologists or psychiatrists. A specific issue order may direct that the child attend therapeutic sessions or assess the suitability of medication. The child’s wishes, particularly during their teenage years, will also be considered under the welfare checklist, which is used by judges to balance all relevant factors and help them make a decision.
A parent cannot simply withhold mental health support by asserting a general preference; their view must be weighed against formal clinical opinion and the child’s wellbeing.
Elective or cosmetic treatment
Disagreements also occur around elective procedures such as orthodontics, grommet insertion, or corrective surgery where benefits are real but not urgent, and opinions differ on timing or necessity.
For example, a separated couple might disagree on whether a 12-year-old should undergo a cosmetic dental procedure that is not medically required but would improve confidence.
In such disputes, the court carefully assesses:
- The medical evidence on benefits and risks
- The child’s own view (especially if over 12 and mature)
- Whether the procedure is urgent or can be delayed
The court may choose to authorise the procedure, postpone a decision until further evidence is provided, or make no order if it determines it is not necessary to intervene. The key is that a specific issue order must reflect what is genuinely in the child’s best interests, not simply which parent wins the argument.
Beyond court: mediation and dispute resolution
It is worth stressing that litigation is rarely the best first step. Judges and court rules strongly encourage parents to seek agreement wherever possible, not only to reduce conflict, but because cooperative decision-making tends to produce better long-term outcomes for children. Mediation, family therapy, or joint consultation with healthcare professionals can often resolve disagreements without court involvement.
Children’s voices matter
An aspect frequently misunderstood by separating parents is the role of the child’s own views. As children grow older and show increasing maturity, their own preferences are considered through the welfare checklist under the Children Act.
While a child’s wishes are not determinative, they are an important factor, especially in non-life-threatening treatment decisions where the child shows clear understanding of the issues. The threshold for giving significant weight to a child’s view rises with age and maturity, particularly in teenagers.
When disputes escalate: involvement of professionals
In some cases, disputes are not resolved between parents and are likely to involve:
- Medical experts, whose written opinions can be crucial to the court’s understanding of risk and benefit.
- CAFCASS officers, who assess the child’s welfare and may make recommendations.
- Social services, in rare situations where withholding treatment amounts to neglect or risk of harm.
Medical professionals will often try to balance parental input with clinical best practice. When they believe a parent’s refusal of necessary treatment is harmful, they may advise seeking a court order or, in emergencies, take life-saving measures.
If you have a family law issue and you require legal advice to understand your options, contact specialist family law solicitor Parvien Akhtar. Parvien is an award-winning lawyer with 25 years of experience as a qualified solicitor, and has a proven track record of providing high-quality advice to her clients.
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