Pediatricians have sought ways to accommodate the diverse living and working arrangements of their patients' families when treating children in a non-urgent care situation. One of the challenges faced by families and pediatricians is the need to have someone other than a child's legal guardian accompanies a child for non-emergency visits, such as well-child visits, injuries or evaluation of minor illness. It could be a grandparent, aunt, uncle, nanny or other caregiver who brings a child to be seen by a pediatrician. In order to treat a child in these instances, physicians need to be aware of the consent by proxy rules in their states.
The clinical report, "Consent by Proxy for Non-Urgent Pediatric Care," in the February 2017 issue of Pediatrics (published online Jan. 23), is a revision of a previous clinical report from the American Academy of Pediatrics.
The report offers guidance for pediatric practices on how to establish rules for medical consent and notify families of their policies. The AAP recommends a practice decides uniformly across all its physicians whether to provide non-urgent care to patients without a legal guardian present.
Families should be aware of the practice's rules on the subject and practice staff and legal guardians should work together to ensure consent forms are complete and included in the patient's medical record. Creating a template to be used for all patients can help standardize the information.
When in doubt about informed consent in these situations, pediatricians should use discretion in deciding whether to treat the patient, and the decision should be based on the best interests of the child.