Public Health Law Map - Beta 5 - Medical and Public Health Law Site

Children can be pawns in marital battles. This becomes an issue in medical care if
the child is being abused or if the parents disagree on medical treatment for a child.
Suspected child abuse must always be reported to child protective services. If the
disagreement over medical care threatens to escalate into neglect or physical harm,
this must also be reported to child protective services.
The most difficult cases are those involving disputes over elective care. Legally,
consent from one parent is sufficient. When the child is too young to have an
independent opinion, the physician may choose to treat the child based on the
consent of one parent. If the physician has been refused consent by one parent, it is
less clear that the physician may then seek consent from the other parent. Children
who are mature enough to have an independent opinion should also be consulted. If
the child and one parent agree on a medically reasonable course, the physician
should follow that course. Conversely, since physicians should not force unwanted
care on a mature minor in general, they should be especially reticent to do so if a
parent agrees with the minor.
5. Conflicts between Parents and Children
The parents of a 17 year old may legally retain the right to determine the minor’s
medical care; however, the courts have been reluctant to allow parents to deny
mature minors elective care. Although a physician should find out the legal
requirements in his or her state, in general, physicians may provide birth control
information and counseling, treatment for substance abuse, and treatment for
communicable diseases to mature minors. In some states, minors may be entitled to
consent to such care without their parents’ being informed.
The more difficult cases involve attempts by parents to force care on mature minors.
The most common scenario involves involuntary psychiatric care for an allegedly
drug- abusing or crazy teenager. There is sometimes a fine line between self-
destructive behavior and normal adolescent rebellion. Physicians have an ethical
obligation not to allow psychiatric care to be used to manipulate or punish a
recalcitrant child. Legally, the child could sue for malpractice against the physician
who recommends unnecessary psychiatric care.
6. Statutory Right To Treat Minors
All states have laws that allow children to be treated without the parents’ or
guardian’s consent in certain circumstances. These laws are designed to protect
either the child or the public health of the community. All states allow persons in
need of emergency care to be treated without consent; nevertheless, many hospitals
and physicians have been reticent to treat children without parental consent. To
encourage the prompt treatment of sick and injured children, many states have passed
laws that allow certain relatives of a child to consent to emergency medical care
when the parents are unavailable. Since consent to treatment is not required in true
emergencies, the primary purpose of these laws is to assuage physicians’ fears of
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