The general rules of consent to care for minors apply to school children. The emergency exception, legally mandated care, proxy consent, and prior consent of parents all apply in various school situations.

Parents may sign a proxy consent for medical care if it is required when the child is at school. These often ask for information on preferred physicians and hospitals. All residential schools with students under the age of 18 should require that a proxy consent be part of the student’s admission materials. The extent to which the proxy consent should be relied upon depends on the circumstances and the difficulty of contacting the parents. A physician treating children in a neighborhood public school should rely on proxy consent only to deliver urgent care until the children’s parents can be contacted. (This type of care is usually sheltered under the emergency exception anyway.) If the children are in a residential school and their parents are out of the country, the proxy consent will have to cover all routine and emergency medical care. Such extensive consent is best documented by a power of attorney to consent to the child’s medical care.

If a child is seriously ill or injured, the emergency exception to the need for consent generally applies. Reasonable attempts should be made to contact the child’s parents and to follow their wishes in selecting caregivers, but these should not interfere with getting the child prompt emergency care. The school system should have a formal policy, and preferably a written contract, for ambulance services for children who are seriously ill or injured. Schools need not wait for parental permission to call an ambulance. Paying the ambulance fee is much less expensive than settling the claim on the broken neck that became a spinal cord injury when the teacher carried the child into the office.