RESOURCES:Sex & Relationship Education Guidance

LEGISLATION ABOUT SEX EDUCATION

Currently Sex is covered within the National Curriculum for science, pupils should be taught:
At key stage 1 (5-7)
That humans move, feed, grow, use their senses and reproduce;
To name the main external parts of the human body;
That humans grow from babies into children and then into adults, and that adults can produce babies; and
To recognise similarities and differences between themselves and other pupils.

At key stage 2 (7-11)
That there are life processes common to all animals; and
The main stages of the human life cycle, growth and reproduction.

At key stage 3 (11-14)
That living things have structures that enable life processes to take place;
The ways in which some cell types, including sperm and ovum are adapted to their functions;
The human reproductive system, menstrual cycle, fertilisation, and the role of the placenta;
How the foetus develops in the uterus;
The physical and emotional changes that take place during adolescence; and
That bacteria and viruses can affect health.

At key stage 4 (14-16)
That the nucleus contains chromosomes that carry the genes;
The way in which hormonal control occurs, including the effects of insulin and sex hormones;
The medical use of hormones, including the control and promotion of fertility and the treatment of diabetes;
How variation may arise from both genetic and environmental causes;
That sexual reproduction is a source of genetic variation while asexual reproduction produces clones;
How gender is determined in humans; and
The basic principles of genetic engineering, cloning and selective breeding.


Learning and Skills Bill 2000

Clause 117 of the bill updates and amends the Education Act 1996
 Local education authorities no longer have any responsibility for sex education in maintained schools; this now rests with the school´s governing body and head teacher. [(2) and (3)]
 The Secretary of State for Education is now required to issue guidance on the delivery of sex education in schools. The guidance must ensure that when pupils receive sex education in schools they learn about the nature of marriage and its importance for family life and the raising of children. Also pupils are to be protected from teaching materials that would be considered inappropriate when bearing in mind the age, religion and culture of the pupils. [(4) 1A]
 The guidance must also include guidance on the use of any materials produced by NHS bodies intended for use in schools for the purposes of sex education. [(4)1C]
 School governors and head teachers are required to bear this guidance in mind when fulfilling their obligations as outlined in the Education Act 1996. [(4)1B]
 The Secretary of State reserves the right to revise the guidance given under subsection (1A) at any time. [(4)1C]
 When formulating their statement of policy on sex education, the governors and head teachers of a school are now required to include in this policy a statement on the effect a parent´s decision to withdraw their child from the school´s sex education programme.

Sex and Relationship Guidance. Ref: DfEE 0116/2000

This guidance is designed to replace that previously provided under Department of Education Circular 5/94.
 The guidance aims to address uncertainty as to what sex and relationship education (SRE) is and how it should be delivered. The document is intended to support head teachers, teachers and governors when defining and delivering sex education in schools.
 Advice and guidance on developing a policy for sex and relationships education and how to work with parents and local communities is included along with information on where the Department sees SRE fitting into a schools´ wider Personal Social and Health Education framework.
 Specific advice is provided on teaching strategies for SRE and particular issues that may arise. Information is given on devising a confidentiality policy and discusses situations where it may not be possible to guarantee confidentiality issues.
 Although this document has the status of ´good practice´, the recent passing of the Learning and Skills Bill (see above) has meant that the legal requirements of teachers and governors have now changed. When providing sex and relationships education it is required by law that young people are made aware of the nature of marriage and its importance for family life and the raising of children. It is also required that young people are protected from ´inappropriate teaching materials´.
A copy of the guidance can be downloaded from the Department for Education and Employment´s website at this address

Education Act 1996

This act was introduced to consolidate the Education Act 1944 and other legislation relating to education. The substance of the law relating sex education was not changed in any way, merely re-affirmed by the new act. Details are given below:
 Section 352 states that the curriculum for every grant maintained school should include a basic curriculum that includes provision of sex education for all pupils and also for those students in special schools receiving secondary education.[Section 352 (c-d)]
 For the purposes of the Education Act 1996 -as with the Education Act 1993- sex education is defined as specifically including information about AIDS and HIV and other sexually transmitted diseases. [Section 352 (3a)]
 The governing bodies of schools decide (bearing in mind their LEA´s policy statement) whether sex education should be part of the school´s secular curriculum. They are also required to keep an up-to-date statement of their sex education policy. This should include information on the content of sex education and where in the curriculum it takes place. [Section 371 (a-b)]
 Sex education should be provided in such a way that it encourages "…pupils to have due regard to moral considerations and family life."[Section 403 (1)]
 Emphasized that schools are required to ensure that their sex education policy is kept up-to-date and available for consultation by parents of pupils at the school. Copies should be made available to parents free of charge if required. [Section 404 (a-b)]
 Re-affirmed the right of parents to withdraw their children from sex education lessons occurring outside the National Curriculum. [Section 405]
(Education Act 1993: Sex Education in Schools)

Department of Education Circular 5/94 (Not legally binding)
 Provides guidance on statutory sex education in schools in light of the changes introduced by the Education Act 1993.
 Highlighted need for caution when giving contraceptive advice to pupils under 16 years i.e. below the age of consent (for heterosexuals). "The general rule must be that giving an individual pupil advice on such matters without parental knowledge or consent would be an inappropriate exercise of a teacher´s professional responsibilities". [Section 39]

Education Act 1993

 Made sex education including education about HIV, AIDS and STDs statutory in maintained secondary schools and special schools.
 Established the right of parents to withdraw their children from sex education provided outside the National Curriculum. [Section 241]
 Amended the Science Orders of the National Curriculum to remove any references to HIV, AIDS, STDs and human behaviour other than the biological aspects.
 Required the governing bodies of all maintained school to write and keep up-to-date a statement of the schools policy regarding sex education. The policy should be made available to parents for inspection and copies provided free of charge.

Department of Environment Circular 12/88 (not legally binding)

 Clarified the position of schoolteachers and governors with regard to the issue of sexuality within sex education. "Section 28 does not affect the activities of school governors, nor of teachers. It will not prevent the objective discussion of homosexuality in the classroom, nor the counselling of pupils concerned about their sexuality." [Section 20]

Local Government Act 1988

 Section 28 of the act stated that a local authority was not permitted to "…promote the teaching in any maintained school of the acceptability of homosexuality as a pretended family relationship."
 The act does not apply to school governors or teachers as clarified in the Department of Environment Circular 12/88(see below).

Education Reform Act 1988

 Required maintained schools to implement a curriculum that "…prepares such pupils for the opportunities, responsibilities and experiences of adult life." [Section1(2)]
 National Curriculum Science was required to cover human reproduction.

Education (No.2) Act 1986

 Required Local Education Authorities to make available to schools a statement of their policy relating to the secular curriculum.
 School governors and head teachers were given the authority to decide whether and how sex education would be covered in school. Also required to keep up-to-date a written statement of the schools sex education policy, mentioning where in the curriculum sex education is to be covered.[Section 18]
 Established that sex education in grant-maintained schools was the responsibility of school governors and head teachers. Sex education was to be provided in such a way as to "…encourage those pupils to have due regard to moral considerations and the value of family life." [Section 46]

Consent to Medical Treatment or Advice

Material Risks
• Defined as those to which a reasonable person in the patient´ position would be likely to attach significance.

• Bolam test = A practitioner can expect to avoid liability if the court finds that a reasonably competent practitioner in a similar position would not have mentioned the risk, and that such a decision was supported by a responsible body of relevant professional opinion.

• Sidaway case -">In some cases a practitioner may reasonably omit to mention a material risk if, after proper consideration of the patient´s condition, he believes that a warning would be harmful to the patient´s health (Therapeutic Privilege).

• The practitioner must be mindful of the severity and likelihood of the risk compared with the need for the procedure. It may be appropriate to warn of a relatively rare risk for a non-therapeutic procedure, such as sterilisation or a screening test. Whereas a similar risk for an important therapeutic procedure may not require specific warning because of the possibility of deterring a patient inappropriately from a necessary treatment.

• Rogers v Whitaker (Court of Australia) -">A risk is material if a reasonable person in the patient´s position, if warned of the risk, would be likely to attach significance to it.

• Finlay CJ, Irish courts -">´If a medical practitioner charged with negligence defends his conduct by establishing that he followed a practice which was general and which was approved of by his colleagues of similar specialisation´s and skill, he cannot escape liability if in reply the plaintiff establishes that such practice has inherent defects which ought to be obvious to any person giving the matter due consideration.´



Alterations & Abbreviations
No alterations should be made to the consent form after it has been signed by the patient.

No abbreviations should be used.

Competent Adult
Criteria for a patient to make treatment decisions:

1. Comprehend and retain the information.

2. Believe the information.

3. Weigh the information in the balance and arrive at a choice.

Minors
Family Law Reform Act, 1969
• Legal age of consent = 16 years & older.

• At age 16 and 17 years it is wise to discuss treatment with the parents.

• Parents and others can act in loco parentis in authorising treatment for a child. A competent child cannot always veto treatment which his parents have authorised.

The Gillick Judgement, 1985
re Consent for Contraception, but applies generally.

The practitioner can proceed without the parent´s consent or knowledge if:

1. The patient understands the advice.

2. The practitioner cannot persuade the patient to inform her parents.

3. She is likely to continue with sexual intercourse without contraception.

4. Her physical or mental health are likely to suffer without treatment.

5. It is in the patient´s best interests to proceed without parental consent.

These ´Fraser Guidelines´ produced the concept formerly referred to as ´Gillick competence´ = children under 16 can consent to treatment only if they truly understand its nature, purpose and hazards.

Children in Care
When a child is subject of a care order, the local authority can authorise treatment on behalf of a child, since it has ´parental responsibility´. Social workers must inform parents, where practicible. However, if a child is being accommodated on a voluntary basis, the local authority does not have parental responsibility.



Incompetent Adults
F v West, Berkshire, 1989
• Where a patient temporarily, or permanently, lacks the capacity to give or to express consent to treatment, it is axiomatic that treatment necessary to preserve the life, health or well-being of the patient, may be given without consent.

• The professional must act in accordance with a responsible body of relevant professional opinion (Bolam).

• It is good practice to involve others in the decision-making process, such as relatives and others concerned with the care of the patient.

• This applies to unconscious patients, also.

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