Guardianship

In general, parental consent is required for the medical treatment of children.  States have traditionally recognized the right of parents to make health care decisions on their children's behalf on the presumption that before reaching the age of majority (normally age 18), children lack the judgment and maturity to make fully informed decisions.  Parents are considered the “natural guardians” of their children, and it is assumed that parents will make treatment decisions in their children’s best interests.  Occasionally, a court will appoint another person to act as the “legal guardian” or “legal custodian” of a child with authority similar to that of a parent to make medical treatment decisions on behalf of the child. 

Nemours strives to obtain consent to treat minors from the minor’s parent/legal guardian in all instances and anticipates the parent/legal guardian will be present with their child at all visits.  Many minor children, however, live with and are well cared for by members of their extended families or others.  As a result, occasionally a minor requiring treatment will not be accompanied by the parent/legal guardian, and efforts to obtain consent to treat the minor from the minor’s parent/legal guardian may be unsuccessful.  In these circumstances, Nemours will look to the law of the state where medical treatment is sought to determine if other persons have authority under law to consent to medical treatment on behalf of the minor.  In general:

• In Florida, a person who possesses a power of attorney to provide medical consent to the minor, the stepparent of the minor, the grandparent of the minor, an adult brother or sister of the minor, or an adult aunt or uncle of the minor, in the order of priority listed, may consent, if the parent/legal guardian cannot be contacted. 

• In Delaware, an adult possessing a relative Caregiver’s Medical Authorization affidavit may consent.  Anyone who wishes to obtain this form may do so by contacting their local Delaware Service Center, Public Health Clinic, or the Division for Aging and Adults with Physical Disabilities or their local school district office.

• In Pennsylvania, an adult who is a relative or family friend possessing a Medical Care Authorization may consent.  A sample authorization form is contained in Purdon's Pennsylvania Statutes and Consolidated Statutes, Title 11, Chapter 21, §2513. 

• In New Jersey, an adult who has care and control of the child if authorized in writing may consent. 

Finally, depending on state law, limited circumstances may exist where a minor is permitted to consent to medical care without consulting his or her parent/legal guardian or obtaining their permission.

Questions about documentation authorizing medical decision making will be handled by the Nemours Legal Department. Any Nemours Associate may contact this department for clarification on your behalf.