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 accompany 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.
American Academy of Pediatrics is an organization of 66,000 primary
care pediatricians, pediatric medical subspecialists and pediatric
surgical specialists dedicated to the health, safety and well-being of
infants, children, adolescents and young adults. For more information,
and follow us on Twitter @AmerAcadPeds.