Law and Minors
Emergencies
Emergency = Life threatening or health threatening situation that requires immediate treatment.
Treatment can be given when the consent of the patient or substitute decision maker cannot be obtained.
Under US and Canadian common law, when patient or substitute decision maker refuses treatment and is competent, then treatment cannot be given.
However:
- Laws and statutes have been put in place in the different provinces to extend the emergency exemption rule, so that treatment can be given where there is a serious threat to health.
- In the US a number of well-recognized exceptions to this "general rule" have been outlined in common and statutory law to allow for the treatment of minors without parental consent in situations that frequently occur in Emergency Rooms (ERs)
The onus of proof is on the HCP to demonstrate that consent was not required in those particular circumstances.
Parent refusal of needed care (when time permits) is dealt with by legal proceedings which establish if the child is decisionally capable or in need of protection.
In the US at least 2 - 3% of pediatric patients seek medical treatment in the ER unaccompanied by a legal guardian.
Current state and federal laws and medical ethics recommendations support ER treatment of minors with an emergency medical condition, regardless of consent issues.
It is recommended that every clinic, office practice, and Emergency room develop policies and guidelines regarding consent for the treatment of minors.
The HCP should document all discussions of consent and attempt to seek consent for treatment from the family or legal guardian and assent from the pediatric patient.
The recommendation in the policy statement below is that appropriate medical care for the pediatric patient with an urgent or emergent condition should never be withheld or delayed because of problems with obtaining consent.
Policy Statement: Consent for Emergency Medical Services for Children and Adolescents by Committee on Pediatric Emergency Medicine
