October 25, 2012

Question:

Jennifer, 

A minor came in for treatment this afternoon accompanied with a nanny.  I did not know what to do.  I refused to see the child.  Did I do the right thing?

Thanks,
Dr. L

Answer:

Absolutely, assuming I have all relevant facts.  In NY who may consent for a patient's treatment is governed by NY Public Health Law s. 2504, which provides that only a parent or an individua with "person in parental relation" may consent to care for a minor.  Here is the statute, also on our website

§ 2504.  Enabling certain persons to consent for certain medical, dental, health and hospital services

   1. Any person who is eighteen years of age or older, or is the parent of a child or has married, may give effective consent for medical, dental, health and hospital services for himself or herself, and the consent of no other person shall be necessary.

2. Any person who has been married or who has borne a child may give effective consent for medical, dental, health and hospital services for his or her child. Any person who has been designated pursuant to title fifteen-A of article five of the general obligations law as a person in parental relation to a child may consent to any medical, dental, health and hospital services for such child for which consent is otherwise required which are not: (a) major medical treatment as defined in subdivision (a) of section 80.03 of the mental hygiene law; (b) electroconvulsive therapy; or (c) the with-drawal or discontinuance of medical treatment which is sustaining life functions.

3. Any person who is pregnant may give effective consent for medical, dental, health and hospital services relating to prenatal care.

4. Medical, dental, health and hospital services may be rendered to persons of any age without the consent of a parent or legal guardian when, in the physician's judgment an emergency exists and the person is in immediate need of medical attention and an attempt to secure consent would result in delay of treatment which would increase the risk to the per-son's life or health.

5. Where not otherwise already authorized by law to do so, any person in a parental relation to a child as defined in sec-tion twenty-one hundred sixty-four of this chapter and, (i) a grandparent, an adult brother or sister, an adult aunt or un-cle, any of whom has assumed care of the child and, (ii) an adult who has care of the child and has written authorization to consent from a person in a parental relation to a child as defined in section twenty-one hundred sixty-four of this chapter, may give effective consent for the immunization of a child. However, a person other than one in a parental rela-tion to the child shall not give consent under this subdivision if he or she has reason to believe that a person in parental relation to the child as defined in section twenty-one hundred sixty-four of this chapter objects to the immunization.

6. Anyone who acts in good faith based on the representation by a person that he is eligible to consent pursuant to the terms of this section shall be deemed to have received effective consent.

DOH has addressed this issue and references the above statute on its website, located here -  http://www.health.ny.gov/nysdoh/ems/policy/99-09.htm.

If you are looking to have on a file a form for a parent to consent to patient care, below is the form set forth under NY PHL s. 2504 -

Parent's Consent--Medical Treatment for Child

 
I, ________________ , the undersigned, of ___________________________________ [ insert street address], City of ___________________, State of New York, declare:
 
I am the _________________ [father or mother] of _________________, a minor. I have been fully informed by Doctor ________________ of the hazards and possible consequences, as well as the alternative methods of treatment, involved in treating the minor by means of _____________ for the relief of ________________________ [indicate condition to be treated]. I hereby consent to such treatment for the minor by Doctor _____________________.
 

Dated   _______________________, 2012.


By: ___________________________________________
     [Signature of parent]