H E A L T H L A W COMPLICATIONS: Informed Consent and Treating Minors in Urgent Care ■ JOHN SHUFELDT, MD, JD, MBA, FACEP John Shufeldt is chief executive officer of NextCare, Inc. and sits on the Editorial Board of The Journal of Urgent Care Medicine. 34 The Journal of Urgent Care Medicine | October 2006 © Elenathewise/Fotolia S TATES HAVE ENACTED STATUTES, and courts have prof- fered an abundance of case law on the treatment of minors. There have been no reports of physicians being held liable for rendering emergent or urgent care to minors prior to obtaining parental consent. Still, informed consent issues surrounding the care and treatment of minors are often a source of confusion and are, at best, problematic. Essentially, competency to give consent is determined in the same way for both minors and adults: Ⅲ Does the individual understand what he or she is consent- ing to? Ⅲ Can the person paraphrase the information given? Ⅲ Can the patient think in the abstract and have an under- standing of the future consequences of either accepting or refusing the treatment? Ⅲ Is the decision entered into voluntarily, without duress? Ⅲ Given the nature of the decision, does the patient under- stand the risks and benefits and its reversibility? If a minor is legally capable of giving consent, the patient’s right of confidentiality also attaches. However, it is prudent to try to per- suade the minor to allow notification of the guardian so the par- ent can take part in the decision-making process; this is especial- ly preferable if the minor is seriously ill. Statutes allowing minors to consent do not mandate parental notification unless the fail- ure to do so would place the minor in additional risk. Historically, issues surrounding parental availability were uncommon. Today, however, family dynamics have changed and children may be left unattended for long periods or left in “Competency to give consent is determined in the same way for minors and adults.” the care of siblings, neighbors, grandparents or babysitters. Dur- ing these times, who can consent for the child’s care? Who can refuse care and how does an urgent care provider sift through this web to do what is best for the child? Low Risk: Emergency Care The most clear-cut scenario is when an emergency situation exists. Care should never be delayed while waiting for consent when evaluating a child with an emergency condition. In an emergent or urgent situation, any patient young or old can be w w w. j u c m . c o m