Chiropractic in a lifetime, family model can be a lot of fun. It can also bring some risks with it. This is especially true if you are taking care of children in situations where the family is experiencing separation, divorce, custody issues and any of the other numerous challenges families have.

Typically, consent to manage a minor is simple and straightforward: have the patient’s parents sign an informed consent document allowing their minor child to be managed by you.

Pretty straightforward.

Now – is it OK to just have one parent’s signature?

Most likely if the parents are married and there are no custody issue then having one parent’s signature is fine. Would it be better to have both – of course. Use your imagination to think about situations that could arise where even though the parents are married and there are no custody issues that disagreements about health care could arise between the parents. It shouldn’t take too much imagination to come up with some possible scenarios. We’ve seen plenty.

The point here is the risk to you. You do not want to be caught in the middle of marital disagreements surrounding the health care of children. So it is always best practices to get both parents’ signatures on the consent.

Another issue that may arise is where there are custody issues due to separation, divorce or impending divorce. The only option here is to make sure you have consent from both parties unless a court or judge has ruled that one parent has the sole authority to make medical and health care decisions.

But you won’t know if you don’t ask. And we can tell many stories where one parent or the other didn’t want the chiropractor to know that there were custody issues that included this type of nuance. You have to ask. If you don’t – you put yourself at risk.

There is nothing more destructive than a parent who has been deceived and that wrath will be taken out on anyone involved – including you.

Another situation that arises is when a minor gets to driving age and no longer wants to come to the office with mom or dad but wants to come by themselves. That is not ordinarily a problem as long as you have additional consent to see the child without a parent or guardian present.

One piece of advice on this though – even if you have consent to see the child without the parents present, do not put yourself in a situation where you are ever alone with the child – male or female. Always have a chaperone present. If it comes down to who said or did what and there is no witness – you are going to be guilty until proven innocent.

Finally, the issue of guardians also comes up – can the parent give permission for a guardian to bring the child in for care? Or are there situations where a guardian has been appointed?

The answer to both is yes.

The parents would simply put the name of the guardian on the consent form. In the case of a guardian that has been appointed by the courts or a foster care situation – just make sure the guardian has the appropriate paperwork so its documented that they have the authority to make health care decisions for the child.

This is not meant to be an exhaustive review of consent issues related to minors but we covered the major ones. When faced with a unique situation on this always ask yourself if proceeding forward will put you in any risk and if so dig deeper before acting.

Check your paperwork and make sure you have all your consent forms lined up and if not check the members only section of the ChiroFutures website.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
drmccoy@chirofutures.org
CEO & Co-Founder
ChiroFutures Malpractice Program 
http://www.chirofutures.org