special subjects
Consent and Surrogate Decision Making
Children
In most states, children below the age of 18 years do not have the Legal capacity to give medical consent. Therefore, for most nonemergency medical decisions affecting minors, medical care cannot proceed without a parent’s or guardian’s consent. The parent’s or guardian’s decision can be overridden only if a court determines that the decision constitutes neglect or abuse of the child. There are two main exceptions. First, emancipated minors can consent to all medical treatments on their own behalf. Second, in most states, minors can consent to certain medical treatments (eg, treatment of sexually transmitted infections, prescriptions for birth control, abortion, treatment of drug and substance use, mental health treatment) without parental permission. Individual state law must be consulted. 