Consent for Care

The final consideration in this case is the patient’s ability to provide consent for care. Usually, the teenaged patient needs parental consent to seek care in the ED unless it falls under the emergency-consent exception. The exception is based on the premise that a reasonable person would not want to be denied necessary medical care because they were too incapacitated to consent to the treatment. This usually applies to potentially life- or limb-threatening conditions. Many states specifically authorize minors to consent to contraceptive services, testing and treatment for human immunodeficiency virus and other sexually transmitted diseases, prenatal care and delivery services, treatment for alcohol and drug abuse, and outpatient mental health care, without parental involvement or consent. Each state has different nuances within these categories and legal consultation can be crucial in the ED when dealing with these issues.

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Case Resolution

You place a call to your on-call hospital lawyer. The state does not require mandatory reporting of sexual violence, and the age of consent is 16 years of age. In addition, the ages of the perpetrators do not fall under the mandated-reporter statute. The SANE nurse is consulted, and she is able to discuss the reporting options available; the patient chooses to do an anonymous report with evidence collection. Lastly, because she is seeking care around a sexual health/sexually transmitted infection issue, you are able to treat her without parental consent.

Dr. Rozzi is an emergency physician, director of the Forensic Examiner Team at WellSpan York Hospital in York, Pennsylvania, and chair of the Forensic Section of ACEP.

Dr. Riviello is chair and professor of emergency medicine at the University of Texas Health Science Center at San Antonio.

Reference

1. Bailey C, et al. Mandatory reporting and adolescent sexual assault. Trauma, Violence, & Abuse. 2023;24(2):454-467.