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Proxy Consent for Minors

Since there is no legal right to provide nonemergency care without parental consent, the child is usually denied care if the parent is not available. A typical case involves a child who is injured while visiting with friends in another community. Less commonly recognized is the problem of children who are visiting with a noncustodial parent in a state that does not give that parent the right to consent to medical care for the children.

Parents or guardians may delegate the right to consent to medical care for a child to another competent adult. Physicians should encourage patients to identify persons who may consent to their child's care if they are not available. As with all other delegations of authority to consent to medical care, these persons must be competent adults. If the child's medical record contains an authorization for proxy consent, the physician will be able to treat the child even if a parent is not available. Most parents have signed a proxy consent form for school or summer camp. Few parents think about signing a proxy consent when the child visits with an out-of-town relative.

The basic form for proxy consent for a child identifies the child, the person delegating the right to consent, the legal relationship of the person to the child, the care for which the delegation is made, and the duration of the delegation. It is also important to include specific medical information if the child has special medical needs. The extent to which the right to consent is delegated should depend upon the expected delay in notifying the person with the legal right to consent. The form to allow the teacher at a day school to take a child to the emergency room would be much more limited than the form for a teenager going on a six-week wilderness trip in Alaska.

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