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M09.03.012 Withholding Treatment from Minors
In healthcare, the ethical and legal frameworks surrounding the treatment of minors often raise complex issues, particularly when it comes to parental consent and the withholding of treatment. Understanding the guidelines and legal implications is crucial for healthcare providers.
Key Principles
Parents generally do not have the right to withhold life- or limb-saving treatments from their children. If parents refuse consent for treatment, the following protocols should be observed:
Emergency Situations
- Immediate Emergency: Proceed with treatment regardless of parental consent.
Critical but Non-Emergency Situations
- Non-Emergency Critical Conditions: In cases such as juvenile diabetes, where treatment is essential but not immediate, the child may be declared a ward of the court. In this situation, the court can grant permission for treatment.
Non-Life-Threatening Situations
- Non-Critical Conditions: For treatments that are not life- or limb-threatening (e.g., minor stitches), healthcare providers should respect the parents’ wishes and listen to their decisions.
Important Notes
- A child who cares for siblings after school is not considered an emancipated minor. Emancipation typically requires legal action or meeting specific criteria.
- Exams will not typically cover controversial topics that involve varying state laws.
Consent Scenarios
The following table outlines various scenarios and who provides consent in each case:
| Situation | Who Provides Consent |
|---|---|
| A 17-year-old girl’s parents are out of the country, and she is with a babysitter. | The mother; writes the prescription. |
| A 17-year-old girl living independently and taking care of herself. | The girl herself. |
| A 17-year-old girl who is married. | The girl herself. |
| A 16-year-old daughter refuses medication, but her mother consents. | The mother; does not write the prescription. |
| A 16-year-old daughter consents to medication, but her mother refuses. | The mother; do not write the prescription. |
| A mother of a minor consents to medication, but the father refuses. | Consent from only one parent is required; write the prescription. |
Points to Remember
- Legal Authority: Physicians may act under the doctrine of in locum parentis in emergencies.
- Ward of the Court: In critical situations where treatment is refused, legal intervention may be necessary.
- Parental Rights: Consent from one parent is sufficient for treatment unless otherwise stipulated by law.
Bibliography
- American Academy of Pediatrics. (2019). Consent for Medical Treatment in Minors. Retrieved from AAP Policy Statements.
- Code of Federal Regulations. (2020). Title 45: Public Welfare, Part 164. Retrieved from CFR.
- U.S. Department of Health and Human Services. (2021). The Health Insurance Portability and Accountability Act of 1996 (HIPAA). Retrieved from HHS.gov.