physician treating minor who refuses treatment

A psychiatrist, a psychologist, an independent social worker, or a marital and family therapist may provide outpatient mental health treatment for a minor without the consent or notification of a parent or guardian under the following conditions: the minor would otherwise reject treatment, treatment is clinically indicated,

Full Answer

When is it necessary to treat a patient who refuses treatment?

It may also be necessary to treat patients who refuse treatment in emergencies where capacity is likely to be impaired but there is not sufficient time for its assessment. What legal frameworks are currently in use?

Can a psychiatrist treat a minor without a parent's consent?

A psychiatrist, a psychologist, an independent social worker, or a marital and family therapist may provide outpatient mental health treatment for a minor without the consent or notification of a parent or guardian under the following conditions: the minor would otherwise reject treatment, treatment is clinically indicated,

How do you deal with a minor patient seeking medical treatment?

Encourage the minor patient to involve his or her parents and offer to facilitate conversation between the patient and the parents. Inform the patient that despite the physician’s respect for confidentiality the minor patient’s parents/guardians may learn about the request for treatment or testing through other means (e.g., insurance statements).

What happens if a parent refuses to treat a child?

If a parent or guardian is refusing to provide specific recommended medical treatment, a third party may petition the probate court to order the treatment against the parent's or guardian's wishes. 39 WHEN A MINOR CAN RECEIVE TREATMENT WITHOUT AUTHORIZATION OF PARENT OR GUARDIAN

What is it called when a doctor refuses to treat a patient?

If you need urgent medical attention, and a doctor refuses to treat you, you can pursue a medical malpractice suit against the physician and/or the establishment they work for. This is especially true for doctors in hospitals and emergency rooms.

Can a doctor choose not to treat a patient?

Justice dictates that physicians provide care to all who need it, and it is illegal for a physician to refuse services based on race, ethnicity, gender, religion, or sexual orientation. But sometimes patients request services that are antithetical to the physician's personal beliefs.

Can a doctor withhold treatment?

Can a physician refuse to treat a current patient? Yes, but the physician needs to follow appropriate guidelines. See California Medical Association (CMA) guidelines in regard to terminating the doctor/patient relationship.

Can parents refuse medical treatment for their child?

Parents have the responsibility and authority to make medical decisions on behalf of their children. This includes the right to refuse or discontinue treatments, even those that may be life-sustaining. However, parental decision-making should be guided by the best interests of the child.

What are the 4 D's of medical negligence?

Deviation from expected standard of care could fall into any of the following: Misdiagnosis or missed/delayed diagnosis. Birth injury. Surgical error.

Are doctors legally obligated to help?

The medical regulatory authorities (Colleges) generally view physicians as having an ethical duty to do their best to attend to individuals in need of urgent care.

Is withholding medication a crime?

Deliberate negligence This involves a caretaker or family member deliberately choosing not to provide medication to the elderly individual. Even if the first few times were accidental, refusing to correct the issue can lead to any potential criminal charges being upgraded from negligent to deliberate.

Is it ethical to withhold treatment?

While there may be an emotional difference between not initiating an intervention at all and discontinuing it later in the course of care, there is no ethical difference between withholding and withdrawing treatment.

Can a doctor refuse to perform a procedure?

Physicians have an obligation to treat patients in an emergency situation to the best of their ability. Physicians can refuse to treat a patient when the treatment request is beyond the physician's competence or the specific treatment is incompatible with the physician's personal, religious, or moral beliefs.

Can doctors override parents decisions?

However, there are situations where doctors can disagree with a parent's decision if a child is in a severe medical dilemma. The parens patriae doctrine gives the state the right to intervene with a parent's decision when it's believed they are not acting in the best interest for the child's well-being.

Can doctors override patients?

It can be ethically acceptable to override a stated wish because it is in the patient's best interest. Some patients request aggressive interventions before a major change in their medical condition and expected outcome.

Should a doctor be able to provide medical care to a minor despite their parents wishes?

Under the law, children are entitled to protection and appropriate medical treatment despite their parents' religious views. Most states require parents to provide a reasonable degree of medical care for their children. Otherwise, they may face legal consequences, regardless of their religious beliefs.

When treatment over a patient's objection would be appropriate?

KP: A simple example of when treatment over a patient’s objection would be appropriate is if a psychotic patient who had a life-threatening, easily treatable infection was refusing antibiotics for irrational reasons. Treatment would save the patient’s life without posing significant risk to the patient.

What are the first few questions in a treatment plan?

The first few questions consider the imminence and severity of the harm expected to occur by doing nothing as well as the risks, benefits, and likelihood of a successful outcome with the proposed intervention. Other questions consider the psychosocial aspects of this decision—how will the patient feel about being coerced into treatment? What is the patient’s reason for refusing treatment? The last question concerns the logistics of treating over objection: Will the patient be able to comply with treatment, such as taking multiple medications on a daily basis or undergoing frequent kidney dialysis?

Is there anything out there to help health care professionals approach the problem of delivering medical treatment against the wishes of patients?

And there are fairly clear policies and laws concerning the ethics and legality of delivering psychiatric care to patients who refuse it. But there is nothing out there to help health care professionals approach the problem of delivering medical treatment against the wishes of patients who lack decisional capacity.

Can you force dialysis on a patient who resists?

As Dr. Rubin stated, one cannot force three times weekly dialysis sessions on a resistant patient even if it means that the patient will die without the treatment.

What to do if it is unclear whether the patient has capacity to refuse treatment?

Seek specialist advice (for example, from a psychiatry team) if it is unclear whether the patient has capacity to refuse treatment and which legal framework should be used

What are the three legal frameworks for treating someone who refuses treatment?

In essence, there are three legal frameworks for treating someone who refuses treatment: (the) common law, the 2005 MCA, 4 and the 1983 MHA. 5 All clinicians need to be familiar with these frameworks (table 1 ⇓ ).

Why is it important to not assume lack of capacity?

In less clear cut cases of delirium it is important not to assume lack of capacity because the patient has a history of mental illness. It is also important not to assume that all behavioural change in a patient with severe mental illness is due to the mental illness because this risks other treatable causes, such as delirium, being missed. Sometimes it can be difficult to distinguish between mental disturbance caused by an organic illness (such as delirium) or a primary mental illness (such as relapse of schizophrenia). In such cases it is advisable to seek specialist support from a liaison psychiatry service or on-call psychiatrist.

When acting against a patient's wishes, is the MCA used?

As a general rule, when acting against a patient’s wishes, the MCA is used to treat physical disorders that affect brain function and the MHA is used to treat primary mental (psychiatric) disorders. In part two of the case scenario the patient’s behaviour has changed.

Why is informal treatment no longer appropriate?

The full reasons why informal treatment is no longer appropriate are documented; include mental state abnormalities and potential risks to the patient or others (or both)

What is the first step in a mental health case?

The first is to determine the urgency of treatment to see whether common law is applicable. The second is to determine what is being treated—a primary physical (organic) disorder or a primary mental (psychiatric) disorder. We will now explain how to work through these two steps as we look at the evolving case scenario.

When can MCA be used?

Summary points. Common law can be used to treat patients in emergencies, especially when the diagnosis is unclear. It allows necessary and proportionate restraint until Mental Capacity Act (MCA) or Mental Health Act (MHA) assessments are completed. The MCA can be used to restrain and treat patients without capacity (for a specific decision) ...

What is the guidance for treating a minor?

Guidance when treating a minor - the minor's rights, the parents' rights, and non-parental consent situations. Unless limited by court order, parents have the rights and duties to provide for their minor child, including providing the child with medical care. However, situations arise when it is difficult for a physician to determine when ...

What is consent for treatment of minors?

The Texas Medical Association (TMA) whitepaper Consent for Treatment of Minors (members only) provides guidance, including situations involving examination for abuse and neglect, consent for counseling, immunization or sterilization, and more.

What is the age limit for consent to treatment in Texas?

armed forces; is (a) 16 years of age or older and resides separate and apart from the child's parents, managing conservator, or guardian, ...

What is a consent to the diagnosis and treatment of an infectious, contagious, or communicable disease?

consents to the diagnosis and treatment of an infectious, contagious, or communicable disease that is required by law or a rule to be reported to a local or state health department, including all diseases in Section 81.041 , Health and Safety Code; is unmarried and pregnant and consents to hospital, medical or surgical treatment related to ...

What is a minor in Texas?

The Texas Statutes Family Code 101.003 defines a Child or Minor: A child or minor means a person under 18 years of age who is or has not been married or has not had the disabilities of minority removed for general purposes.

When can other people give consent?

When the person having the power to consent cannot be contacted and actual notice to the contrary has not been given, other persons and entities can give consent; however, there must be written authorization to do so.

Can a physician rely on a written statement of the child?

A physician may rely on a written statement of the child containing the grounds on which the child has capacity to consent to his/her medical treatment. That written statement should be retained in the patient's file. The Texas Statutes Family Code 32.003 Consent to Treatment by Child states:

What does the court consider when deciding a child's refusal?

Courts also consider whether the parent (s) agree with their child’s refusal. While parents’ rights can be trumped by the state, courts provide a great deal of latitude for parental decision making, as in E.G.’s case when the mother’s agreement may have ultimately determined the court’s decision [9]. In contrast, when the court did not believe the child had a true ability to express his or her wishes (as in Daniel’s case) or did not have an opportunity to hear the child’s perspective (Shannon’s case), it favored protecting the child over granting decision making power to the parents [10, 11].

Why did Daniel refuse chemotherapy?

The refusal was based on their religious practice of Nemenhah, a Native American healing practice in which Daniel was a medicine man and which forbade chemotherapy because of a prohibition against doing harm [10]. Daniel was unable to articulate why he opposed the chemotherapy beyond the notion of “do no harm,” and experts placed his reading below ...

What was the condition of E.G.?

E.G. E.G. was a 17-year-old Jehovah’s Witness with leukemia who refused medically necessary blood transfusions on the basis of religious belief, a decision her mother supported [9]. Without transfusions, professionals expected E.G. to live no more than a month, and either way her long-term prognosis was poor—persons with her condition had a predicted survival rate of 20 to 25 percent [9]. Experts evaluated E.G. and agreed about the following: she was mature (one specialist placed her at the maturity level of someone between 18 and 21), her refusals were based on a sincere religious belief and not a desire to die, and she fully understood that the consequences of her decision would be death [9]. A trial court appointed a temporary guardian for E.G. to consent to transfusions on her behalf and found her mother guilty of medical neglect, but Illinois’ highest court overturned the decision in 1989, holding that E.G. had a right to refuse the blood transfusions and her mother was innocent [9]. (At this point, the case was technically moot for E.G.’s purposes, because she had turned 18.) The court was swayed by the fact that E.G.’s mother agreed with the refusal and suggested that the outcome could have been different if E.G.’s mother had wanted her to seek treatment.

What do courts consider in evaluating a minor?

Lastly, courts consider and evaluate the minor’s competency and level of understanding. Both E.G.’s and Daniel’s cases involved testimony by experts about the minor’s maturity, level of sophistication in articulating their religious views, and understanding of the consequences of refusing treatment [9, 10].

Can a minor give consent to a medical procedure?

Most states provide certain universal exceptions, instances in which minors can give medical consent. One is for emergency care when a parent is not available in time to provide consent [7]. Another exception is for emancipated minors, who are deemed legally independent from their parents in all legal capacities, including medical decisions [7]. Some states have statutes that specify types of care for which parental consent is not required, such as treatment for sexually transmitted infections, treatment for substance abuse or mental health, or requests for contraceptives [8]. Lastly, states may have “mature minor” doctrines, under which minors can petition the court to recognize that they fully understand the treatments and consequences of their decisions and should therefore be allowed to make treatment decisions independently, either in contradiction to their parents’ wishes or without consulting their parents [7]. Courts often view teenagers’ refusal of life-saving therapies as an extension of the mature minor rules.

Is parental consent required for mental health?

Some states have statutes that specify types of care for which parental consent is not required, such as treatment for sexually transmitted infections, treatment for substance abuse or mental health, or requests for contraceptives [8].

Can a teenager refuse lifesaving therapy?

Three stories help illustrate the key considerations a court generally weighs when asked whether a teenager should be allowed to refuse life-saving therapies.

What are the responsibilities of a parent/guardian?

Inform the patient (and parent or guardian, if present) about circumstances in which the physician is obligated to inform the minor’s parent/guardian, including situations when:#N#Involving the patient’s parent/guardian is necessary to avert life- or health- threatening harm to the patient.#N#Involving the patient’s parent/guardian is necessary to avert serious harm to others.#N#The threat to the patient’s health is significant and the physician has no reason to believe that parental involvement will be detrimental to the patient’s well-being 1 Involving the patient’s parent/guardian is necessary to avert life- or health- threatening harm to the patient. 2 Involving the patient’s parent/guardian is necessary to avert serious harm to others. 3 The threat to the patient’s health is significant and the physician has no reason to believe that parental involvement will be detrimental to the patient’s well-being

What is the purpose of confidentiality in counseling?

Protect the confidentiality of information disclosed by the patient during an exam or interview or in counseling unless the patient consents to disclosure or disclosure is required to protect the interests of others, in keeping with ethical and legal guidelines.

What is the role of a minor in decision making?

Physicians also have a responsibility to protect the confidentiality of minor patients, within certain limits. In some jurisdictions, the law permits minors who are not emancipated ...

What to inform a minor patient about a medical test?

Inform the patient that despite the physician’s respect for confidentiality the minor patient’s parents/guardians may learn about the request for treatment or testing through other means (e.g., insurance statements).

Why is it important to involve the patient's parent/guardian?

Involving the patient’s parent/guardian is necessary to avert life- or health- threatening harm to the patient.

When to inform or refer the patient to alternative confidential services?

Inform or refer the patient to alternative confidential services when available if the physician is unwilling to provide services without parental involvement.

Can an unemancipated minor receive confidential care?

Similarly, jurisdictions may permit unemancipated minors to request and receive confidential care to prevent, diagnose, or treat sexually transmitted disease, substance use disorders, or mental illness. When an unemancipated minor requests confidential care and the law does not grant the minor decision-making authority for that care, ...

What does DCF do for children?

When a child is committed to DCF by the Superior Court, DCF may authorize medical and dental treatment to "insure the continued good health or life of the child.". 44 The commissioner must make diligent efforts to inform the parents or guardians prior to the treatment, and must also notify the parent or guardian by letter of the treatment.

What happens if a parent refuses to provide medical care?

If a parent or guardian is refusing to provide specific recommended medical treatment, a third party may petition the probate court to order the treatment against the parent's or guardian's wishes. 39

What is the effect of emancipation?

The effect of emancipation is to release the parent or guardian from all obligations of guardianship and allows the emancipated minor to assume the responsibilities of an adult , including consenting to medical, dental or psychiatric care. 47. MEDICAL RECORDS OF MINORS.

How old do you have to be to be emancipated?

The Commissioner of Correction is authorized to order medical care to any inmate under 18. 46 Reasonable efforts must be made to inform parent or guardian prior to the treatment. A minor who is at least 16 years of age may petition the court for emancipation.

How old do you have to be to get temporary custody of a child?

The minor is financially responsible for the treatment, and payment may not be sought from the parent or guardian. If the minor is under 12 years of age, however, the treating physician must report it to DCF. WHEN A CHILD IS PLACED OUTSIDE OF THE HOME. Temporary Custody.

When a minor can receive treatment without parental permission?

WHEN A MINOR CAN RECEIVE TREATMENT WITHOUT AUTHORIZATION OF PARENT OR GUARDIAN. the minor would otherwise reject treatment, treatment is clinically indicated, the failure to provide treatment would be seriously detrimental to the minor's well-being, the minor has knowingly and voluntarily sought the treatment, and.

Who is responsible for providing all necessary goods and services for their children, including health care?

Parents and guardians are responsible for providing all necessary goods and services for their children, including health care. 37 With a few exceptions, minors may not authorize medical treatment for themselves without the permission of a parent or guardian. 38. WHEN A PARENT OR GUARDIAN DOES NOT WANT A CHILD TO RECEIVE CERTAIN TREATMENT.

What happens if a doctor refuses to treat a UTI?

If someone schedules an appointment for a urinary tract infection (UTI), for example, and the doctor refuses to treat them, the doctor could face liability for delaying care and allowing the UTI to advance into a kidney infection. This is primarily because the doctor will have a hard time explaining to the jury why they did not provide care for an evident UTI when the patient waited for an appointment.

Why can't doctors treat patients?

Yes. The most common reason for refusing to treat a patient is the patient’s potential inability to pay for the required medical services. Still, doctors cannot refuse to treat patients if that refusal will cause harm.

Why do doctors ask for insurance information?

Most doctors request payment or insurance information when patients schedule their first appointment because they will be obligated to treat someone who shows up for an appointment in urgent need of care.

What happens if a doctor terminates your care without notice?

In cases where you already have a doctor-patient relationship with your provider, you may also have a patient abandonment claim if your doctor terminates your care without reasonable notice or excuse during a critical stage of the treatment process.

Do doctors treat attorneys?

Still, some doctors choose not to treat certain classes of patients, and many physicians refuse to treat patients involved in car crashes or accidents that will lead to litigation. Some physicians also refuse to treat attorneys. These decisions are usually made to avoid liability and stay out of court.

Can a doctor refuse to deliver a child?

Although some obstetricians will not treat a pregnant woman who does not seek care within the first 6 months of pregnancy, no doctor can refuse to deliver a child, particularly in a hospital or emergency room setting. Similarly, reproductive doctors cannot refuse to perform an abortion that would preserve the mother’s health – even if abortion is against their religion.

Can a doctor refuse to treat a patient?

Yes. In certain situations, a doctor can refuse to treat a patient. Nevertheless, doctors cannot refuse to treat patients who are in immediate need of care. Emergency department doctors, for instance, have a legal obligation to treat anyone who shows up in front of them.

What happens if you are unfairly denied medical treatment?

If you feel you were unfairly denied medical treatment and as a result, you suffered a worsened condition, you could be entitled to recover monetary compensation for your damages through a medical malpractice claim. To learn more about this process, contact our team of medical malpractice lawyers at Baizer Kolar, P.C. to set up your free legal consultation in our office.

What is disruptive patient?

The patient is disruptive or otherwise difficult to handle ; The doctor does not have a working relationship with the patient’s healthcare insurance provider; The doctor’s personal convictions, such as a doctor refusing to perform an abortion for religious reasons or refusing to prescribe narcotics for pain; and.

Why can't a doctor treat a patient?

There are a few reasons why a doctor can refuse to treat a patient. The most obvious of these is if the doctor does not treat patients with the patient’s specific condition. For example, an individual suffering from a throat infection cannot realistically expect a gynecologist to diagnose and treat his or her condition.

Does Emtala require a hospital?

As its name implies, EMTALA also requires healthcare providers to provide healthcare to a laboring woman until her baby is delivered . Once the baby is born or the patient’s condition is stabilized, healthcare providers are not required to provide further services.

Is it illegal to deny a patient treatment based on their age?

There is one exception to the healthcare provider’s right to deny services: discrimination. Under the Civil Rights Act of 1964, it is illegal for a healthcare provider to deny a patient treatment based on the patient’s age, sex, race, sexual orientation, religion, or national origin.

Can a doctor deny you medical treatment?

Yes, a doctor can deny you medical treatment. Private doctors have some more leeway to deny treatment to patients than those in Medicare-compliant hospitals, but there are circumstances under which even doctors serving Medicare patients may choose not to serve a patient.

Who is a medical malpractice lawyer?

The patient or the patient’s spouse is a medical malpractice lawyer.

TMA Guidance

Rights of A Minor

• The Texas Statutes Family Code 101.003(a) states: A child or minor means a person under 18 years of age who is or has not been married or has not had the disabilities of minority removed for general purposes. Generally, minors do not have the legal capacity to consent to medical treatment; however, Texas Statutes Family Code Chapter 31identifies an...

See more on hcms.org

Rights of The Parents

Non-Parental Consent