Understanding medical agreement for treatment procedures
Consent to treatment is a crucial aspect of medical care, involving an individual's agreement to receive medical services, tests, and examinations. This article explores the specific legal and ethical considerations surrounding consent for children, young people, and those on life support.
For minors (typically under 18 years old), parent(s) or legal guardian(s) must provide legal consent for medical treatment. This includes mental health or substance use treatment, where parental consent is generally required before starting treatment. Providers usually require a parent or guardian to be present for the initial appointment for minors under age 13, and strongly encourage it for adolescents aged 13-17.
Emancipated minors, those legally recognized as self-supporting, married, active military, or court-declared emancipated, have the legal right to consent to their own medical, dental, or mental health treatment without parental consent. Self-sufficient minors, under some state laws, may also consent to their own care if they meet certain criteria, but this varies by jurisdiction and is subject to legal restrictions.
In cases where a child is not legally capable of consenting but is capable of understanding their treatment, the concept of assent applies. Even when a parent/legal guardian provides consent, the child's willingness (assent) to proceed is ethically important and often required in practice.
For those on life support, consent typically rests with the legal guardian or healthcare proxy unless the patient has previously communicated advance directives. Emergency situations may override consent requirements to provide life-saving care. Where a caregiver holds notarized consent authorization, healthcare providers must honor their decisions unless there is actual knowledge of conflicting parental or guardian decisions.
Key legal and ethical principles that guide consent procedures for minors include parental or guardian authority to protect the child's welfare through informed consent, respect for the minor’s developing autonomy through assent appropriate to their maturity, consideration of emancipation or legal status granting minors independent consent rights, requirements for documentation of consent and clear clinical protocols to verify authority, and exceptions for emergencies where consent may not be required to provide urgent treatment.
People who are aware that their capacity to consent will change in the future may create a living will or appoint a lasting power of attorney (LPA) to make medical decisions on their behalf. Once a person gives consent, they have the right to change their mind and withdraw consent at any point. Consent to treatment is an important and necessary part of medical treatment, and individuals have the right to refuse treatment, request alternative treatment, or withdraw consent at any time.
This framework ensures minors receive appropriate medical care while balancing parents' rights and children's growing capacity for decision-making. Consent laws vary by jurisdiction, so providers must be familiar with relevant state or country-specific statutes and institutional policies.
[1] Children's Hospital of Philadelphia. (2021). Consent and Assent. Retrieved from https://www.chop.edu/centers-programs/ethics/programs/pediatric-ethics-consultation-service/consent-and-assent [2] American Academy of Pediatrics. (2019). Policy Statement: Adolescent Consent for Health Services. Retrieved from https://pediatrics.aappublications.org/content/144/6/e20192330 [3] National Conference of State Legislatures. (2021). Minors' Consent to Health Care. Retrieved from https://www.ncsl.org/research/health/minors-consent-to-health-care.aspx [4] American Medical Association. (2019). Code of Medical Ethics Opinion 2.10: Consent to Medical Treatment. Retrieved from https://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-on-ethical-and-judicial-affairs/reports/ama-code-of-medical-ethics-opinion-210-consent-to-medical-treatment [5] American Psychological Association. (2013). Ethical Principles of Psychologists and Code of Conduct. Retrieved from https://www.apa.org/ethics/code/index.aspx
- In cases concerning minors, parents or legal guardians must provide legal consent for various medical treatments, including mental health and substance use treatment, while the child's assent is ethically important.
- Self-sufficient minors, under certain state laws, may have the legal right to consent to their own medical, dental, or mental health treatment without parental consent, provided they meet specific criteria.
- For those on life support, consent usually rests with the legal guardian or healthcare proxy unless the patient has previously communicated advance directives.
- Consent laws vary by jurisdiction, necessitating that healthcare providers be familiar with relevant state or country-specific statutes and institutional policies.
- Mental health, therapies, and treatments, as well as other medical procedures such as surgery, are crucial aspects of health-and-wellness, and individuals have the right to refuse, request alternatives, or withdraw consent at any time.
