WHO CAN CONSENT TO MEDICAL TREATMENT?[1]

Emergency Medical Treatment / Routine Medical Care[2] / Extraordinary Medical Treatment[3] / Commitment to Mental Health Facility[4] / ECT[5] / Sterilization / Abortion
Child in DCF custody pursuant to a C&P or 23(a)(3) (formerly 23C) petition[6] / No consent required (c.112, §12F; 110 CMR 11.03(3)) / DCF (110 CMR 11.04) / Judicial consent required / DCF up to 90 days, judicial approval required for continued commitment (110 CMR 11.16(4)) / Judicial consent required (110 CMR 11.15(3)) / Judicial consent required (110 CMR 11.11; Matter of Moe, 385 Mass. 555 (1982) / Only child may consent, subject to judicial approval (c.112, §12S; 110 CMR 11.07(2))
Child in DCF custody pursuant to a CRA petition[7] / No consent required (c.112, §12F; 110 CMR 11.03(3)) / DCF (110 CMR 11.04) / Parent / Parent (110 CMR 11.16(3)) / Parent (110 CMR 11.15(2)) / Judicial consent required (110 CMR 11.11; Matter of Moe, 385 Mass. 555 (1982) / Child and parents must consent, or child must obtain prior judicial approval (c.112, §12S; 110 CMR 11.07(1))
Emergency Medical Treatment / Routine Medical Care[8] / Extraordinary Medical Treatment[9] / Commitment to Mental Health Facility[10] / ECT[11] / Sterilization / Abortion
Child in “care” of DCF pursuant to a voluntary agreement or 23(a)(1) petition / No consent required (c.112, §12F; 110 CMR 11.03(3)) / DCF (110 CMR 11.04)[12] / Parent / Parent (110 CMR 11.16(3)) / Parent (110 CMR 11.15(2)) / Judicial consent required (110 CMR 11.11; Matter of Moe, 385 Mass. 555 (1982) / Child and parents must consent, or child must obtain prior judicial approval (c.112, §12S; 110 CMR 11.07(1))
Child subject of a guardianship under G.L. C. 190B, § 5-306A. / No consent required (c.112, §12F; 110 CMR 11.03(3)) / Guardian (G.L. c. 190B, § 5-209) / Judicial consent required / Judicial consent required / Judicial consent required / Judicial consent required (110 CMR 11.11; Matter of Moe, 385 Mass. 555 (1982) / Only child may consent, subject to judicial approval (c.112, §12S; 110 CMR 11.07(2))

[1] Certain minors have the right to consent to medical treatment. See c.112, §12F (emancipated minors); Baird v. Atty. Gen’l, 371 Mass. 741 (1977) (mature minor doctrine).

[2] Under DCF regulations, minors may give consent to certain routine medical treatment, but if the minor is unable to consent, or in some cases, if the minor refuses to give consent, DCF may consent to the treatment. See 110 CMR 11.05 (family planning services); 11.06 (pregnancy); 11.08 (drug dependency); 11.09 (diseases dangerous to the public health); 11.10 (venereal disease).

[3] Includes no-code orders (110 CMR 11.12); giving or withholding of life-prolonging medical treatment (110 CMR 11.13); antipsychotic medication (110 CMR 11.14); and other extraordinary medical treatment as defined by regulation and case law (110 CMR 11.17).

[4] A child 16 or older may apply for voluntary admission to a mental health facility. See 110 CMR 11.16(2); 104 CMR 27.06(1); c.123, §10(a). In addition, a child 16 or older who has been admitted upon the application of a parent or DCF, has the right to leave the facility. See 104 CMR 27.06(7).

[5] Except if a child is 16 or older and (a) is not a patient at a mental health facility, or (b) is on voluntary admission status or conditional voluntary admission status to a mental health facility, only the child may consent to administration of ECT. See 110 CMR 11.15(1).

[6] Includes children who are the subject of an emergency removal under c.119, §51B prior to the first court appearance. See 110 CMR 11.02.

[7] 110 CMR 11.02 provides that for purposes of 110 CMR 11.00 et. seq. only, a child committed to DCF under a CRA petition is considered a child in the “care” of the department, and thus for purposes of determining who may consent to medical treatment a committed CRA youth is treated the same as a child in the “care” of the Department pursuant to a voluntary placement agreement.

[8] Under DCF regulations, minors may give consent to certain routine medical treatment, but if the minor is unable to consent, or in some cases, if the minor refuses to give consent, DCF may consent to the treatment. See 110 CMR 11.05 (family planning services); 11.06 (pregnancy); 11.08 (drug dependency); 11.09 (diseases dangerous to the public health); 11.10 (venereal disease).

[9] Includes no-code orders (110 CMR 11.12); giving or withholding of life-prolonging medical treatment (110 CMR 11.13); antipsychotic medication (110 CMR 11.14); and other extraordinary medical treatment as defined by regulation and case law (110 CMR 11.17).

[10] A child 16 or older may apply for voluntary admission to a mental health facility. See 110 CMR 11.16(2); 104 CMR 27.06(1); c.123, §10(a). In addition, a child 16 or older who has been admitted upon the application of a parent or DCF, has the right to leave the facility. See 104 CMR 27.06(7).

[11] Except if a child is 16 or older and (a) is not a patient at a mental health facility, or (b) is on voluntary admission status or conditional voluntary admission status to a mental health facility, only the child may consent to administration of ECT. See 110 CMR 11.15(1).

[12] Except under 110 CMR 11.04(3), when a child is in the care of DCF pursuant to a voluntary placement agreement, the parent may refuse to delegate to DCF the authority to consent to routine medical care if such treatment conflicts with the parent’s religious beliefs.