Parents and legal guardians generally have the right — as long as they are not acting irresponsibly — to give consent for their minor child's medical treatment. In some cases, preteen and teen children are asked or required to give their "assent" to medical treatment. This is a lesser standard than informed consent; it indicates simply that they have been told about the treatment and agree to it.  "Informed consent" is a legal term referring to the right of individuals to make medical decisions only after full disclosure of relevant information.

Consent by teenagers who are minors is complex and raises numerous legal issues. A state-by-state listing of laws governing assisted treatment is available at www.psychlaws.org/LegalResources/ATCriteria.htm. In some states, under certain conditions, the laws treat a teenager the same as a younger child, giving parents and guardians the right to give consent for their teenager's medical treatment. But there are numerous exceptions to this general rule. For example, some states have laws that:

• set an age under 18 at which a teen may refuse medication or treatment.
• set an age under 18 at which a minor can obtain, without parental knowledge or consent, treatment for substance abuse (a condition that may coexist with bipolar disorder).
• give teens over a particular age the right to psychological treatment by a therapist without the parent or guardian's knowledge or consent.
• restrict the authority of a treating facility to use force to return a runaway teen to the facility.

The rights of a minor to refuse treatment vary by state. In some states, the parent or guardian can consent to the child's treatment. Other states permit minors to refuse treatment once they reach a specific age. Teenagers with bipolar disorder may have distorted thought processes in which they are unaware that they have any illness at all (this symptom is called "asonognosia"), or they may pronounce themselves "cured." They may strongly resist treatment even while their behavior is out of control. Such teens may not be competent to make their own medical decisions.

Minors treated in residential treatment facilities may or may not be forcibly returned to the facility if they run away. State laws, regulations and policies vary greatly. For example, in California minors who have reached age 14 are entitled to a hearing to determine if their parent can require them to remain in inpatient treatment. Before admitting your teenager to a facility, find out what rights minors in your state have should they want to be discharged.

If your child is at or near the age of majority, consider the use of an advance directive. This is a legal document in which a patient specifies what is to be done if that person is unable to make sound judgments concerning his or her own health care. It usually names another person to make decisions on that person's behalf. An attorney in your state should be consulted to prepare this document. A sample psychiatric advance directive is provided on the website of Bazelon Law Center, www.bazelon.org/advdir.html.

The enforceability depends upon state laws. In some states, consumers can revoke the directive at any time, including during a period of instability. In some states an advance directive can be overruled by a emergency situation, by a court order for treatment or by a guardian. An article analyzing the various state advance directive statutes may be found at the NAPAS website. (National Disability Rights Network)

(For a discussion of issues involving informed consent for participation in research studies , see The Balanced Mind Foundation's Research Page at www.thebalancedmind.org/lrn_research_studies.)

Disclaimer

Families with legal problems are urged to hire a capable local attorney licensed to practice in the state in which the family resides. The Balanced Mind Foundation (The Balanced Mind Foundation) is unable to provide you with legal advice and The Balanced Mind Foundation’s attorneys are unable to represent you.

The information on this web page is not a substitute for legal advice. It is intended to be general in nature. The laws of each state are different.The law is always changing. The information here may not reflect the latest legal developments. NO WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, IS GIVEN AS TO THE ACCURACY OF THIS INFORMATION.