College and high school athletes pose additional problems. Persons under the age of 18 are legally able to make their own medical decisions only in certain situations established by state law. Most states allow minors to consent to treatment for substance abuse, communicable diseases, pregnancy, and other conditions that pose a threat to persons other than the minor. No state specifically authorizes minors to consent to treatment for sports injuries. Sports medicine may not be practiced on minors without parental consent and this parental consent is constrained by the child welfare laws.

Parents may consent only to medical care that is in the child’s best interest. If a physician believes that a medical regime chosen by the parents is not in the child’s best interest, the physician must report this to the child welfare authorities. Children themselves are unable to balance the desire to get back in the game against the risk of permanent injury. A child who is later unable to continue in athletics or is otherwise disabled may sue the physician for malpractice. Physicians should not allow the enthusiasm of child athletes or their parents to weigh in medical decisions that will affect the long-term health of the child. Most parents will not persist if they are fully informed as to the risks of continued participation by an injured child. If the parents continue to pressure the child to engage in unsafe activity, then this becomes a matter of child abuse.