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Medical Law coursework - Essay Example The right of younger children to provide independent consent is proportionate to their competence, but a child's age alone is clearly an unreliable predictor of his or her competence to make decisions. A judgment in the High Court in 1983 laid down criteria for establishing whether a child, irrespective of age, had the capacity to provide valid consent to treatment in specified circumstances. Two years later these criteria were approved in the House of Lords and became widely acknowledged as the "Gillick test," after the name of a mother who had challenged health service guidance that would have allowed her daughters aged under 16 to receive confidential contraceptive advice without her knowledge. As long ago as 1969 the Family Law Reform Act declared that consent to medical treatment given by a minor of sixteen "shall be as effective as it would be if he were of full age," (1969) and in such cases parental consent need not be obtained. The empowered children to make informed decisions based on their competence and capacity. This view of children's legal rights have been strengthened in Gillick v. West Norfolk & Wisbech Area Health Authority (1985) where House of Lords ruling declared that "parental responsibility diminishes as child acquires sufficient understanding to make his own decisions" and that "at common Law a child of sufficient intelligence and understanding could consent to treatment, notwithstanding the absence of parents consent." This judgment clearly and expressly declared that a doctor might provide contraception to minor under sixteen with or without her parents consent. The law did not recognise any rule of absolute parental authority until a fixed age: 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 right to make his own decisions when he reached a sufficient understanding and intelligence to be capable of making up his own mind. This has to be an exercise backed by sound clinical judgment taking into consideration what is best for the patients health. This was further supported by Health's Guidelines for Ethics Committee (1991) which holds that parental consent cannot override a competent child's refusal of consent. This was also supported in 1984 by the British Medical Association's Philosophy and Practice of Medical Ethics (1988) which advises that physicians may provide contraceptive to mentally mature women under sixteen without parental notification or consent if that clinically serves the patients best interest. (Kessel, 1993 ) Here the conflict is between autonomy and dependency, which characterizes the legal position of the minors. This lays emphasis on the rights to decide on the matters of sexuality, reproduction, partnership, marriage and parenthood which are influenced and limited by parental rights and also affected by state regulation. This leads to the more pertinent question of the social rights of minors around the issue of sex education, as one of the most controversial subjects investigated.
The History Of The Family Systems Theory Sociology Essay
The definition of Family has become increasingly controversial over the past few decades. Family in the twenty-first century is different to everyone; all families have different structures and functions, beliefs and parental attitudes. The term family refers to a unit consisting of people who are related to each other either biologically by notions of blood relations, or alternatively by legal means such as by marriage (Kirby, et al 2000, p45).
The definition of a family has changed a lot over the years; there are several reasons for the definition to change. The view of the typical nuclear family is no longer the norm within society. Nowadays there are more families of divorce, stepfamilies, and extended families, rich and poor families. There is not a single definition for what a family is; people have their own view of what a family is. There are many factors that make families different, such as ethnicity, religion, and economics. Levine (N.D) suggests that families have three basic goals for the children; survival, economic self-sufficiency and self-actualization (Enrique, et al, 2007)
Family structure and family functioning can affect a childs development in many ways. Family structure is the way in which a family is set up, for example, single parent families, extended families and nuclear families. Family functioning refers to how family members are emotionally attached, how well they communicate emotions and information and respond to problems (Freistadt and Stohschein. 2012).
Everyone has a different view of what family is and how families should be structured. Some make the assumption that children can only be brought up successfully in a two-parent family structure involving a heterosexual relationship. Others take the perspective that children can function well in any family structure, provided certain basic conditions are met (Wise, 2003).
According to Schaffer family structure plays less importance part in a childs development than family functioning.
The family is a social system endorsed by law and custom to take care of its members needs (Kepner, 1983). The emotional bondings and relationships between the members of the family, and their responsibility to the family unit hold them together through the changes of transitions and the complicated connections.
Family Systems Theory
Murray Bowen developed the family systems theory, he recognised that the family was an emotional unit and any changes to the family functioning would influence all members of the family. The family systems theory emerged from the general systems theory by scholars who found that it had a lot of relevance to families and other social systems. http://web.pdx.edu/~cbcm/CFS410U/FamilySystemsTheory.pdf
The family systems theory refers to a family as a system in which each member can never be considered in isolation without reference to the roles, responsibilities and behaviours of other members of the family. The family is seen a dynamic unit according to the family systems theory. Changes are constantly occurring and each member of the family takes on new roles and responsibilities, and internal patterns are adopted. The relationships between the individuals in the family unit are mutual and constantly changing.
The family is an example of an ongoing, self-regulating, social system that has certain features such as its unique structuring of gender and generation set it apart from other social systems. Each family system has their own structure, the psychobiological characteristics of its individual members, and its sociocultural and historic position in its larger environment (Broderick, 1993, p37).
The family as a system links all individuals together and understands that things going on in the environment can influence all individuals even if not all of them are actively engaged, for example parents workplace. The family system theory recognises that small things can impact the family system, for example, the loss of a parent can affect the relationship the child has with the other parent and/or siblings.
According to Bowen each member of the family system has a roles and boundaries. Individuals in the system are expected to engage with each other in a certain ways according to their role and their relationship with other members.
There are four main principles of the family systems theory; wholeness, integrity of subsystems, circularity of influence and stability and change. Wholeness refers the family as one unit however each member of the family have certain attributes of their own. Integrity of subsystems means that each relationship is a subsystem, for example; mother and father relationship or mother and child relationship or vice versa. Relationships between relationships are also subsystems. Circularity of influences means that the subsystems and relationships depend on each other and if there is a change in one subsystem it has an impact on other systems. Stability and change refers to external influences that can affect the individual or subsystems, for example parents workplace. The wellbeing of the child, therefore, can be conceived of as dependent upon the functioning of elements of the entire family system (McKeown and Sweeny 2001: 6)
Family systems are different in all families. Parental attitudes are important in setting up an environment in which their child can flourish. Campion (1985) says that if a child grows up in a stable and loving environment, the child will usually develop a sense of self-respect and self-discipline. The child understands what is expected of him and
However it can be argued that a child who has been brought up in a family system where the parents attitudes lack maturity, the child is more likely not to flourish in the environment and not understand what is expected of them, therefore cannot develop a sense of their own competence.
Campion (1985) suggests that children take on the roles, which have a function in their family system. It is believed that if children see themselves as the disobedient one in the family setting, they may carry out their difficult behaviours in school. Likewise a child who is obedient may also carry out this behavior at school.
The ecological systems theory
Bronfenbrenners ecological systems theory states that the environment is reflected in an individuals development. Bronfenbrenners ecological approach refers to layers of environmental influences that impact an individuals development. The interactions with people and the environment are key to development. This theory can apply to individuals at any stage of development.
The theory identifies five environmental systems in which the individual interacts with; microsystem, meosystem, exosystem, macrosystem and chronosystem.
The microsystem refers to each setting, which the individual is an active participant, such as; family, school, community, friends. This layer has the most immediate and earliest influences on the child. The relationships in the microsystem can be bi-directional; this means that the childs behaviours can be influenced by the family and vice versa. The meosystem refers to the relationships between the settings in the microsystem and the individual; an example of this would be the relationship between home and school. The exosystem refers to a setting or setting where an event happens, which affects or is affected by what happens in the setting that the developing person is in. The child is not an active participant in this system. The structures in the exosystem can affect a childs development by interacting with the structures in the microsystem, for example; mothers work place can affect the amount of time the mother spends with the child. Although the child is not directly involved with the structures in the exosystem, they do feel the positive and negative impacts that are involved with the interaction between the systems. The Macrosystem refers to the wider social systems, for example; government legislations and economic factors. These things affect the child indirectly however it has an impact on the developing childs life. An example of this could be that the childs family is living in poverty therefore this can cause social exclusion and the child might not have access to school trips or community play areas. The chronosystem refers to how things change over time as it relates to the childs environment. There are various elements within this system that can be internal or external. An internal influence could be the physiological changes that occur while the child gets older. An external influence could the timing of their parents getting a divorce. The older the individual gets might impact how they react to environmental changes and may be able understand how the change will influence them.
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