Every day, parents face difficult medical decisions regarding their children. When a child is sick, parents need to decide when to see a physician or agree to a course of treatment. Other medical decisions are preventative, such as whether to vaccinate a healthy child. What seems like an easy decision for one parent is often a difficult decision for another.
Each parent draws on their own experiences, education, and religious beliefs in making medical decisions for their child. But what happens when a parent makes the wrong decision and denies their child much-needed medical care? When does denying health care become neglect? Can the state intervene to help the child?
When the State Can Make Medical Decisions for a Child
Typically, state laws give parents much leeway in protecting and caring for their children, including providing consent for or refusing medical care. But this isn't always the case if the decision may endanger a child's life.
Although health care decision-making is one of the rights reserved to parents, there are some cases where the state must intervene to protect the child. Many courts will allow a state child protection agency to make medical decisions for a child if:
- The medical community is in agreement about the appropriate course of treatment for the child
- The expected outcome of that treatment is a relatively normal life with a reasonably good quality of life
- The child would die without the treatment
- The parent is refusing to grant consent for the treatment
When the State Cannot Make Medical Decisions
If any of the factors described above are not present, then states typically defer to parents regarding medical treatment for their minor child. Outside of these circumstances, parents have the right to consent or refuse medical treatment for their children.
For example: If a child has a terminal condition and several doctors agree that treatment is no longer beneficial for the child, then the parents have the right to refuse treatment and seek hospice care for their child. This commonly occurs when a child gets a terminal cancer diagnosis and their parents do not want to put them through chemotherapy.
Similarly, suppose different doctors suggest different treatments. In that case, the parent is entitled to choose which doctor's advice to follow without fear of facing criminal charges in what is already a heart-wrenching situation.
States have different laws on the age of consent for medical procedures, so a minor in one state may not be considered a minor in another. This could have major implications for the parent's decision-making ability and whether the state can intervene at all.
Depending on the state, teenagers may have the ability to go to a doctor's office on their own and make decisions regarding their health care without their parents' or the state's consent. Typically, states view 16 or 17-year-olds as non-minor children. Non-minor children are often considered as having the capacity to understand the information provided by a physician and make the appropriate decisions for their own lives.
Reporting Parental Medical Decisions
Generally, each state has its own process for filing a report or notifying child protective services. In most states, anyone can report parents for their medical decision making regarding their children, including:
- The child
- Doctors, nurses, or other medical staff
- Social workers or counselors
- Extended family members or family friends
- Staff members at a child's school
- Other adults in contact with the child, like a coach or mentor
Religious Beliefs are Not a Defense for Denying Treatment to a Child
Adults have the right to refuse their own medical care for religious or personal reasons. However, this legal right to refuse medical care does not extend to their children if it endangers the child's welfare.
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.
Legal Consequences for Parents
State intervention on a medical decision for a minor may go further than just health care. When parents refuse necessary or life-saving care for their child, they could face serious legal consequences as well. States often refer to this as medical neglect and have laws against it.
Loss of Custody
The state may find that the parent is neglecting the child and place them in state custody. Even parents without existing parental custody agreements may lose visitation access. In some cases, the custody order may be temporary, and the parents can regain custody. However, in more extreme cases, a court order may permanently terminate their parental rights.
The parent may face child abuse, child neglect, and assault charges for failing to provide the necessary medical care for their child. A conviction on these criminal charges could mean penalties like time in prison, fines, and mandated parenting classes. Parents convicted of these criminal charges may also lose custody of their parental rights.