title: What constitutes consent when parents and daughters have different views about having the HPV vaccine: qualitative interviews with stakeholders.
abstract: OBJECTIVE
  The UK Human Papillomavirus (HPV) vaccine programme commenced in the autumn of 2008 for year 8 (age 12-13&emsp14;years) schoolgirls. We examine whether the vaccine should be given when there is a difference of opinion between daughters and parents or guardians.
  
  
  METHODS
  Qualitative study using semi-structured interviews.
  
  
  METHODS
  A sample of 25 stakeholders: 14 professionals involved in the development of the HPV vaccination programme and 11 professionals involved in its implementation.
  
  
  RESULTS
  Overriding the parents' wishes was perceived as problematic and could damage the relationship between school and parents. A number of practical problems were raised in relation to establishing whether parents were genuinely against their daughter receiving the vaccine. Although many respondents recognised that the Gillick guidelines were relevant in establishing whether a girl could provide consent herself, they still felt that there were significant problems in establishing whether girls could be assessed as Gillick competent. In some areas school nurses had been advised not to give the vaccine in the absence of parental consent. None of the respondents suggested that a girl should be vaccinated against her consent even if her parents wanted her to have the vaccine.
  
  
  CONCLUSIONS
  While the Gillick guidelines provide a legal framework to help professionals make judgements about adolescents consenting to medical treatment, in practice there appears to be variable and confused interpretation of this guidance. Improved legal structures, management procedures and professional advice are needed to support those who are assessing competence and establishing consent to vaccinate adolescents in a school setting.
authors.affiliation: Department of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, Wales, UK. wood@cardiff.ac.uk
authors.forename: Fiona
authors.initials: F
authors.lastname: Wood
authors.forename: Lucy
authors.initials: L
authors.lastname: Morris
authors.forename: Myfanwy
authors.initials: M
authors.lastname: Davies
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D057828:Informed Consent By Minors / Q000941:ethics*; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D033282:Parental Consent / Q000941:ethics*; D036301:Qualitative Research; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines