One of the more complex issues facing policymakers is establishing rules on minors' consent for medical care. A parent's right to make health care choices for a minor child seems fair and reasonable.
Despite this, the right of young people to access medical services in confidentiality may be more important than parents being informed about their child's medical condition. A parent's involvement may prevent a minor from seeking help, whether they are sexually active, pregnant, infected with an STD, or have mental or emotional problems.
As a result, many states explicitly allow minors to make their own medical decisions, but the balance between parents' and minors' rights remains a controversial issue.
Reasons a Minor May Give Consent Without Knowledge of Parents
There may be instances when treatment is provided without consent, such as in an emergency. Several states have passed laws regarding child medical consent, including emergency medical situations. Treatment under this exception is only offered in the presence of immediate and probable harm.
Court-ordered emancipation
The court may grant emancipation to a child under 18 who lives independently and makes their own day-to-day decisions without parental support. Once approved, the minor will have adult rights, including the ability to consent (and refuse) medical care. The patient's record should include a copy of the emancipation decree if they inform you that they are emancipated.
Situational emancipation
A minor who is married, a parent, attends college away from home, is a military member, or has been a parent may be able to consent to treatment on their behalf in some states. Minors may also agree to treatment if their parents or guardians are not readily available, and a delay in treatment could harm them.
Type of treatment
Treatments for substance abuse, mental health issues, and birth control are often available to minors. This right is granted to minors as young as 12 in several states, including Vermont and California.
It is important to remember that, while minors may meet the legal requirements for consenting to treatment, psychiatrists must still ensure that they possess the maturity and capacity to understand the treatment for which they are consenting.
Because these laws vary across states, psychiatrists need to familiarize themselves with the laws that govern their state. Document the circumstances under which the minor child is permitted to consent to treatment.
Can Minors Refuse Medical Treatment?
The American Medical Association considers informed consent a fundamental ethical and legal right. Despite this, teenagers might be denied their rights and forced into treatment without consent.
However, in the mature minor doctrine, young people are given medical autonomy. According to the doctrine, if a minor shows sufficient maturity and understanding of their condition, they may refuse or consent to treatment without the consent of their parents.
Smith vs. Seibly (Washington Supreme Court, 1967) gave rise to the concept of a mature minor doctrine. When considering whether unemancipated individuals may consent to surgery, the court determined that physicians should consider the following factors:
- Age
- Intelligence
- Maturity
- Training
- Experience
- Level of economic independence
- Adult behavior and freedom from parental control
Furthermore, the court cited Grannum vs. Berard (Washington Supreme Court, 1967). It held that the mental capacity to consent to surgery should be determined based on the particular circumstances of the teenager.
By doing so, a precedent was established for separating similar-aged people.
Age of Child Medical Consent Laws by State
Below, you will find each state's reference information when providing minors with clinical care.
State
|
Routine Health Medical Care
|
Infectious Disease
|
Alabama
|
14 years or older
|
Any minor
|
Alaska
|
A minor living independently from their parents and managing their finances
|
N/A
|
Arizona
|
Emancipated, married, or homeless
|
N/A
|
Arkansas
|
Any unemancipated minor of sufficient Intelligence. McKinney-Vento homeless liaison for unaccompanied homeless youth.
|
N/A
|
California
|
15 years or older
|
12 years or older
|
Colorado
|
14 years or older
|
N/A
|
Connecticut
|
Emergency case, emancipated or married
|
N/A
|
Delaware
|
An individual serving as temporary custodian of a minor
|
12 years or over
|
District Of Columbia
|
11 or older
|
N/A
|
Florida
|
16 and older
|
N/A
|
Georgia
|
Emancipated or married
|
N/A
|
Hawaii
|
14 years
|
N/A
|
Idaho
|
Anyone who understands the risks of health treatments
|
14 years of age or older
|
Iowa
|
16 or older and emancipated, married, or incarcerated
|
Parents do not need to consent to some health care services for minors
|
Illinois
|
14 years
|
N/A
|
Indiana
|
14 years
|
N/A
|
Kansas
|
16 years or over
|
N/A
|
Kentucky
|
A parent, emancipated or married
|
|
Louisiana
|
Any minor who believes themselves to be afflicted with an illness or disease
|
N/A
|
Maine
|
A minor lives separately from parents or legal guardians and is independent of parental support.
|
N/A
|
Maryland
|
Any minor living separate and apart from a parent, parents, or guardian and is self–supporting
|
N/A
|
Massachusetts
|
Self-supporting minors living separately from parents, parents, or guardians
|
Any minor suffering from any disease is defined as dangerous
|
Michigan
|
Being emancipated, living alone, married, pregnant, or a parent
|
|
Minnesota
|
Self-supporting minors living separately from parents, parents, or guardians
|
N/A
|
Mississippi
|
Married or emancipated
|
N/A
|
Missouri
|
16 or 17 years of age
|
N/A
|
Montana
|
Self-supporting minors living separately from parents, parents, or guardians
|
Minors who professes or is found to be pregnant or afflicted with any reportable communicable disease
|
Nebraska
|
Married or emancipated minor
|
Minors may consent
|
Nevada
|
Self-supporting minors living separately from parents, parents, or guardians for at least four months.
|
N/A
|
New Hampshire
|
Emergency care
|
14 years but notify minor's
parent of positive
HIV status
|
New Jersey
|
Married or pregnant
|
13 years or older
|
New Mexico
|
14 years or older
|
N/A
|
New York
|
Parent, married, or in an emergency
|
Parent, married, or in an emergency
|
North Carolina
|
Married, or 16 or older and emancipated, or for emergency care
|
Consent from a parent or legal guardian for under 18 years
|
North Dakota
|
14 years or older
|
N/A
|
Ohio
|
No explicit policy
|
Minors may consent
|
Oklahoma
|
Self-supporting minors living separately from parents, parents, or guardians
|
Any minor who is or has been pregnant
|
Oregon
|
15 years or older
|
15-17 years
|
Pennsylvania
|
Minors of any age whose consent would result in a delay
|
Under 21 years of age
|
Rhode Island
|
16 and over or married
|
Under 18 years
|
South Carolina
|
Minors of any age
|
N/A
|
South Dakota
|
Married or emancipated minor
|
Minors may consent
|
Tennessee
|
16 y or older
|
Minors may consent
|
Texas
|
16 years of age or older
|
A child may consent
|
Utah
|
15 years or older
|
Minors may consent
|
Vermont
|
Emancipated or married
|
12 years old may consent
|
Virginia
|
A minor shall be deemed for birth control, pregnancy, or family planning except for sexual sterilization;
|
A minor shall be deemed to determine the presence of or to treat venereal disease
|
Washington
|
A school nurse, counselor, or homeless student liaison
|
N/A
|
West Virginia
|
Consent rights are supported by judicial opinion for minors with capacity
|
No explicit policy
|
Wisconsin
|
No explicit policy
|
Minors may consent
|
Wyoming
|
A minor living separate and apart from a parent, parents, or guardian and is self–supporting
|
N/A
|
This table shows why it is important to look at the laws in your state before allowing a minor to make medical decisions on their own. In other cases where the child cannot decide, you may need a child medical consent form to give someone else permission to make these decisions.
Read more:Why You Should Prepare a Medical Consent Form for Your Children
Start your Child Medical Consent Form
Helpful Resources:
Emancipation of minors - Cornell Law -
Grannum v. Berard: 1967: Washington Supreme Court Decisions
Smith v. Seibly: 1967: Washington Supreme Court Decisions
The Mature Minor Rule- King County