Read this topic

Gillick competence asks whether a minor understands enough to consent to medical treatment in general; Fraser guidelines are the extra, specific checklist applied only when that treatment is contraceptive or sexual health advice.

• Gillick competence is the general common-law test for whether a person under 16 has sufficient maturity and understanding to consent to medical treatment without parental knowledge or consent.
• It arose from a case where a mother challenged government guidance allowing doctors to give contraceptive advice to under-16s without parental consent; the House of Lords held that a minor with sufficient understanding and intelligence to fully appreciate the proposed treatment could give valid consent.
• Fraser guidelines are the specific five-point criteria (from the same case, articulated by Lord Fraser) that apply only to contraceptive and sexual health advice/treatment for under-16s: the young person understands the advice; cannot be persuaded to involve their parents; is likely to begin or continue having intercourse with or without treatment; their physical or mental health is likely to suffer without the advice or treatment; and it is in their best interests to receive the advice or treatment without parental consent.
• Gillick competence applies broadly to any medical decision by a minor under 16 (e.g. consenting to a procedure, refusing treatment in some contexts); Fraser applies narrowly, only to contraception and sexual health.
• Both frameworks assess a minor's ability to consent to treatment; they do not remove the clinician's separate duty to consider safeguarding, particularly with very young adolescents or where a significant age or power imbalance with a partner is present.
• For those aged 16 and over, capacityA person's ability to understand, weigh up, and use relevant information to make a specific decision.Read more → to consent to medical treatment is generally assessed under the Mental Capacity Act 2005 rather than Gillick/Fraser.

• The patient is under 16 and requesting treatment or advice without parental knowledge.
• The clinical context is specifically contraception or sexual health, cueing Fraser rather than plain Gillick.
• The stem describes assessment of the young person's understanding, maturity, and likely behaviour.
• The vignette tests whether treatment can proceed without parental consent or involvement.

• Gillick competence (general test for any treatment decision by an under-16) vs Fraser guidelines (extra specific criteria applying only to contraception/sexual health) — Fraser sits on top of, not instead of, general competence.
• Under-16 assessed via Gillick/Fraser vs 16-and-over assessed via the Mental CapacityA person's ability to understand, weigh up, and use relevant information to make a specific decision.Read more → Act 2005 — the age cut-off changes which legal framework applies.
• Assessing whether a minor HAS competence to consent (Gillick/Fraser) vs a best interests decision made FOR someone who lacks capacityA person's ability to understand, weigh up, and use relevant information to make a specific decision.Read more → — these are opposite starting points.
• Fraser's 'likely to continue intercourse regardless' criterion (providing contraception reduces risk) vs assuming providing contraception encourages sexual activity — the guidelines exist because withholding advice does not stop behaviour, it just removes protection.
• Meeting the Fraser criteria (treatment can proceed) vs safeguarding concerns still applying (e.g. very young age, coercive relationship) — satisfying Fraser does not switch off the clinician's separate duty to consider safeguarding.

• Assuming Gillick competence and Fraser guidelines are interchangeable names for the same test — Fraser is a narrower, additional checklist specific to contraception/sexual health.
• Assuming Fraser criteria apply to general medical treatment decisions (e.g. surgery) rather than only contraceptive/sexual health contexts.
• Assuming providing contraceptive advice to a Fraser-competent minor requires parental consent — it explicitly does not, once the criteria are met.
• Assuming that meeting Fraser criteria removes the need to consider safeguarding — very young age or an exploitative relationship still triggers safeguarding duties alongside the clinical decision.
• Assuming the Mental CapacityA person's ability to understand, weigh up, and use relevant information to make a specific decision.Read more → Act 2005 applies to under-16s — it generally applies from age 16 upward; under-16 capacity is assessed via Gillick/Fraser.

• First check the age band, under 16 points to Gillick/Fraser; 16 or over points to the Mental CapacityA person's ability to understand, weigh up, and use relevant information to make a specific decision.Read more → Act 2005.
• Next check the clinical context, any general treatment decision uses Gillick competence alone; contraception or sexual health specifically triggers the additional Fraser criteria.
• If Fraser is relevant, verify all five elements are addressed in the stem (understanding, cannot be persuaded to involve parents, likely to continue intercourse regardless, health risk without treatment, best interests of receiving it) before selecting an option that proceeds with treatment.
• Reject any option that assumes parental consent is always mandatory, that Gillick and Fraser are the same thing, or that meeting the criteria removes the need for safeguarding vigilance.