Child Consent

[Run with scissors]

today in class, my teacher was saying that if a child is unconscious on the floor. and the parents said they didn't want the child to be treated. you would treat the child anyways.

why is this? because from my understanding. consent to treat a minor comes from the parents or guardian. so if the parent says they refuse treatment. then wouldn't that be the same thing as the child refusing treatment?

if some one could help me understand this. that would be great. my teacher wasn't very much help at explaining this.

 

[squirrel15]

That should fall under implied consent.

 

[redundantbassist]

I would contact law enforcement and treat the child. Most states have criminal statutes defining when refusal of needed medical care for a child constitutes some form of child neglect or abuse.

 

[Akulahawk]

I would suggest that if you believe that the child is in danger, you should certainly contact law-enforcement as they can take protective custody of child. At that point, you can then begin providing medical care. However, you should be able to very solidly articulate the reason why you believe the child is in danger and refusal of care would constitute child endangerment or child neglect. Ordinarily though, a parent can refuse medical care for their child.

 

[Run with scissors]

It would only be implied cinsent if the parent was not there.

I guess law enforcement would be the only way to handle it.

 

[redundantbassist]

It would only be implied cinsent if the parent was not there.

I guess law enforcement would be the only way to handle it.

I personally would not delay treatment as long as the parents are not violent

 

[Run with scissors]

Idk its a sticky situation. leave it up to the md. They know best I assume

 

[DesertMedic66]

I personally would not delay treatment as long as the parents are not violent

Until PD places the kid under protective custody it is still up to the parents. Treating them may be seen as assult/battery as you did not get consent.

 

[Run with scissors]

Desertmedic, thats exactly what I thought. I dont need an assault and battery on a child charge.

 

[CALEMT]

Until PD places the kid under protective custody it is still up to the parents. Treating them may be seen as assult/battery as you did not get consent.

This. Implied consent means nothing if the parents refuse treatment for the child. Implied consent applies when the kid is injured or needs medical treatment/ transport and there is no legal parent or guardian around to give consent.

 

[redundantbassist]

If I ever found myself in a scenario where there was a child with a condition so severe that there was a possibility he would die before LE would arrive, and parents were refusing, I would gladly accept any consequences in a heartbeat in order to preserve the child's life.

 

[Carlos Danger]

today in class, my teacher was saying that if a child is unconscious on the floor. and the parents said they didn't want the child to be treated. you would treat the child anyways.

why is this? because from my understanding. consent to treat a minor comes from the parents or guardian. so if the parent says they refuse treatment. then wouldn't that be the same thing as the child refusing treatment?

if some one could help me understand this. that would be great. my teacher wasn't very much help at explaining this.

It depends on the specifics of the scenario. What reason are the parents giving for not wanting you to treat the child (i.e. does he have frequent seizures, and is just post-ictal)? How are they acting? Does the kid look sick/injured? Signs of trauma?

That should fall under implied consent.

It's not implied consent because the people who can give consent - the parents - are present and able to give consent.

If I ever found myself in a scenario where there was a child with a condition so severe that there was a possibility he would die before LE would arrive, and parents were refusing, I would gladly accept any consequences in a heartbeat in order to preserve the child's life.

This. All day long.

 

[Tigger]

American Pediatric Association's position statement: http://pediatrics.aappublications.org/content/128/2/427.full

Involve law enforcement and medical control quickly. At least here, significant dispatches involving children will get law enforcement response, even here in the big city, so we don't deal with terrible delays. If there was no other option, I would scoop and run with the child hoping that I will be judged as doing what another reasonable provider would do faced in the same situation.

 

[squirrel15]

It's not implied consent because the people who can give consent - the parents - are present and able to give consent.


This. All day long.

When taking the kid who is unconscious and treating them against the parents will in order to preserve the life of the child, what justification would you use down the road once it went to court? You would involve PD and go the route child neglect/abuse, and then use implied consent for treatment of the patient, correct?

 

[Run with scissors]

When taking the kid who is unconscious and treating them against the parents will in order to preserve the life of the child, what justification would you use down the road once it went to court? You would involve PD and go the route child neglect/abuse, and then use implied consent for treatment of the patient, correct?

Its still not implied consent. Once law enforcement has custody of the child. They will be consenting to your care for the child.

But as for the court justification. I think there are too many hoops to jump through to actually be prosecuted. First of all. You have no immediate proof that the person refusing treatment was the guardian. Until documentation is present on demand at the site. Which im sure no one realistically carries around birth certificates. So a grab and scoop would be a good option in that situation. Everything else would be considered for the good of the child.

 

[chaz90]

We can't let the exaggerated threat of legal action scare us into inaction on these rare cases. If we, as EMS, are presented with a pediatric patient in an immediately life threatening situation and parents/guardians refusing care we do have a duty to act. We need to be careful about what we define as "immediately life threatening" as abdominal pain, shortness of breath, or the average allergic reaction or traumatic injury certainly do not qualify.

We spend so much time worrying about legal cases and going to court, but reality doesn't reflect those fears from an EMS standpoint. There are certainly religions and various belief systems in which parents attempt to withhold medical care from their children, but these battles aren't fought in the field. Many states have very explicit rules regarding parent's rights to refuse lifesaving medical care for minor children, but you'll note that all of these legal battles and news stories are fought once the child is in the hospital receiving treatment.

We're not expected to be legal experts skilled at interpreting the nuances of legal custody laws and medical decision making for minors. When presented with a critically ill/injured child, the right decision from a moral and legal standpoints until everything can be sorted out is to provide immediate treatment and transport, involving LE as necessary.

 

[Carlos Danger]

We spend so much time worrying about legal cases and going to court, but reality doesn't reflect those fears from an EMS standpoint.

This.

First, the best legal protection you can provide yourself is to always provide good care. When in doubt, always just act in the best interest of the patient. It is a lot easier to defend prudent action - both legally and ethically - than it is to defend inaction that resulted in patient harm.

Second, my moral duty always comes before my legal one. Just because something may be illegal doesn't mean it's the wrong thing to do.

 

[Household6]

This.

First, the best legal protection you can provide yourself is to always provide good care. When in doubt, always just act in the best interest of the patient. It is a lot easier to defend prudent action - both legally and ethically - than it is to defend inaction that resulted in patient harm.

Second, my moral duty always comes before my legal one. Just because something may be illegal doesn't mean it's the wrong thing to do.

So much yes in this post.. I'd rather defend myself in court for saving a life, than look in the mirror and know I chose not to, but could have..

It seems in my old age I base a lot of my decisions on how I will look myself in the mirror at the end of the day.

 

[Run with scissors]

So much good input. Thank you all for your perspectives.