(3) (4) grandparent, an adult child or a brother or a sister of the user. in the specific order as listed; (c) the provision of a health service without informed consent is authorised in terms of any law or court order; (d) failure to treat the user, or group of people which includes the user will, in the reasonable opinion of the health practitioner, result in a serious risk to public health; or (e) any delay in the provision of the health service to the user might result in his or her death or irreversible damage to his or her health and the user has not expressly or by conduct refused that service. A health practitioner shall take all reasonable steps to obtain the user's informed consent. Any health practitioner who fails to comply with subsections (2) and (3) shall be guilty of an offence and liable to a fine not exceeding level ten or imprisonment not exceeding one year or both such fine and such imprisonment.” This provision goes hand in hand with another provision, which is section 44 of the same Act: “44 Participation in decisions (1) (2) (3) A user has the right to participate in any decision affecting his or her personal health and treatment. If the informed consent of the user is given by a person other than the user, such person must, if possible, consult the user before giving the required consent. If a user is unable to participate in a decision affecting his or her personal health and treatment, he or she must be informed after the provision of the health service in question.” Essentially, the Act retains the position that children require parental or adult consent to access medical health services in terms of exiting law, although new provisions are added. These additional provisions give medical practitioners a leeway to treat children when an adult has not provided the informed consent on behalf of the child in situations where failure to treat the child, or group of people which includes the child, will, in the reasonable opinion of the health practitioner, result in a serious risk to public health; or any delay in the provision of the health service to the child might result in his or her death or irreversible damage to his or her health. [See subsection 35(2) paragraphs (d) and (e) above]. Added to the new Act is the right to be heard for a child, who must be consulted before an adult gives consent. This accords with the right to be heard – which is one of the four cardinal principles of child protection. Underlying any legal reform should be a practical realisation and acceptance that children are, in fact, engaging in sexual activity among themselves. Coming with that are unwanted pregnancies, and sexual and reproductive health issues, which are matters we cannot afford to ignore ironically in the name of protecting the children. 16