Medical Consent for Minors: Balancing Confidentiality, Compassion & the Law

Tamara Johnson answers the frequently asked questions our risk team receives about treating minor patients and parental consent for medical care.

As risk consultants, we’re frequently asked about situations involving minor patients who arrive for or make appointments without a parent or guardian present. Whether due to scheduling conflicts, logistical issues, or confidentiality concerns, this scenario is increasingly common—and it presents unique ethical, legal, and interpersonal challenges. Keep reading for Curi's insights on navigating these circumstances when they arise.

Key Takeaways:

• Every state has minor consent to medical treatment laws, which fall into two categories: the status of the minor or the type of treatment requested. Know your state’s laws.
• Work with parents to establish clear boundaries and expectations for chronic or ongoing care of unaccompanied minors.
• In all situations with minor patients, communication and empathy are vital. Examining and treating minors without a parent present is always a nuanced situation.

The Legal Landscape: Consent & Confidentiality

In my experience, the first thing to consider when treating a minor is consent. By law in most states, those under 18 years of age generally require a parent or legal guardian to consent to medical care. This is straightforward when a parent is present, but things become more complicated in their absence.

When can a minor give consent for medical treatment? Some states and circumstances do grant minors the right to consent for themselves—typically for sensitive services such as sexual health, mental health, and substance abuse treatment. These exceptions have been designed to safeguard adolescent health, ensuring that barriers like embarrassment or fear don’t prevent necessary care. We recommend a policy outlining your state laws and when a minor can make healthcare decisions without parental consent.

Case Examples

FAQ: A 16-year-old drove himself to his appointment. Can we see him without one of his parents present?

A: I received a call from one of our pediatric practices with a situation about a 16-year-old patient. The young man had driven himself to his medical appointment, and no parent or guardian was present. “Can we still see him?” I was asked. I followed up with a few clarifying questions: Does your practice allow minor patients who are old enough to come to the office alone? Do you have a consent for treatment of a minor child from the parents allowing him to be seen alone? Is this a routine or urgent appointment?

As they gave more details, it became clear that there was no signed consent for treatment of a minor child form on file, and the appointment was not for a life-threatening emergency.

I walked them through best practices to protect both the minor’s confidentiality and the organization’s liability, ensuring they’re operating within minor consent to medical treatment laws. This includes having a standard authorization form that parents can sign in advance of appointments to authorize the clinicians to treat their child in their absence. This is especially important for teens who drive themselves or get dropped off.

FAQ: How do we manage treatment disputes between divorced parents?

A: Recently, I consulted with a medical office asking about a dispute over a minor patient’s treatment concerning a stepmother. The administrator explained that the natural mother communicated that the stepmother could not consent to medical treatment, but the natural father stated that the stepmother could. “Whose directive do I follow?” she asked.

I recommended the following best practice: Write a letter to both the natural mother and the natural father, advising them of the situation and stating that non-emergency care will not be provided to the child until the natural parents resolve their differences amongst themselves. State that they must provide a letter signed by both natural parents indicating who can consent to treatment.

Then, I reminded the administrator that, unless a court has revoked one parent’s rights or entered an order that prevents one parent from making healthcare decisions for the minor patient, both natural parents have an equal right to request and consent to treatment for their child. I suggested that if a dispute persists and no consensus on consent can be reached, the administrator should consult with legal counsel or the organization’s ethics committee.

I added that care should never be discontinued due to parental disputes if stopping treatment could be life-threatening, but that clarification of consent should still be obtained after treatment and documented in the minor’s medical record. I ended our call by sharing that while this is a difficult letter to write, having clear guidance in writing will protect the practice’s liability and improve patient care in the long run.

FAQ: A 15-year-old presented for an appointment without their parent requesting an exam for a sexually transmitted infection diagnosis and treatment. Do we provide care or call the parents and request consent?

A: A family practice administrator contacted us with the above situation. Our advice is that when treating adolescents, we encourage parental involvement. If a minor is reluctant to involve a parent, we suggest exploring their reasons and trying to address any misconceptions. Sometimes, facilitating honest communication between teens and their parents can lead to better outcomes. However, if their wishes are firm and if the law allows it, healthcare professionals should respect their decision to seek care alone.

The clinician and minor should reach an understanding concerning:

• The extent to which the parents or guardians will be informed,
• who is responsible for paying the cost of the medical treatment, and
• to whom the clinician can disclose the medical information that is necessary to obtain payment for the treatment.

Communication & Empathy: Best Practices

In all situations with minor patients, communication and empathy are vital. Examining and treating minors without a parent present is always a nuanced situation. Healthcare professionals should balance legal requirements, ethical considerations, and individual rights of young patients.

Our advice is to always err on the side of communication, consent, transparency, and compassion so that minor patients—whether accompanied or not—receive care, respect, and support.

Curi Resources

Curi clients, sign in to our Risk Solutions Resource Catalog to access resources related to the treatment of minors:

• Risk Management Guide: Treatment of Minors
• Informed Consent Form - Consent for Treatment of Minor Child

If you have questions about this topic, please call 800-328-5532 to speak with one of Curi Advisory's Risk Solutions Consultants.

Additional Resources

• Confidential Health Care for Minors | AMA-Code
• AMA Code of Medical Ethics’ Opinion on Adolescent Care | Journal of Ethics | American Medical Association
• State & Federal Compendium — Teen Health Law

Curi’s risk mitigation resources and guidance are offered for educational and informational purposes only. This information is not medical or legal advice, does not replace independent professional judgment, does not constitute an endorsement of any kind, should not be deemed authoritative, and does not establish a standard of care in clinical settings or in courts of law. If you need legal advice, you should consult your independent/corporate counsel. We have found that using risk mitigation efforts can reduce malpractice risk; however, we do not make any guarantees that following these risk recommendations will prevent a complaint, claim, or suit from occurring, or mitigate the outcome(s) associated with any of them.

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