Who Can Make Health Care Decisions for Teens?

As teens move closer to the legal line of adulthood, their maturity and decision-making abilities are not as clearly delineated as the date of their 18th birthday. “Growing up” is a process that takes many years, varies from person to person, and frequently depends on circumstances.

Many teens are interested in privacy and control with respect to their health information, particularly regarding their sexual well-being and mental health. The legal age for providing medical consent in Washington is 18. However, there are certain circumstances wherein teens can make medical decisions and provide their own medical consent at a younger age, without the approval of a parent; there are also circumstances wherein they’re entitled to confidentiality of their medical information. 

Washington views categories of health care with respect to teen consent as follows:

Mental Health — Anyone 13 or older may provide consent for themselves for outpatient mental health services by a licensed medical professional. Anyone 13 or older may provide consent for themselves to be admitted to inpatient mental health services without parental consent as long as notice is provided to the parent.

Sexual/Reproductive Health — Regardless of age, family planning and pregnancy care—including contraceptives and abortions—may be provided confidentially, without parental consent. Testing, diagnosis and medical care for STDs (including hepatitis B and HPV immunization) may be provided if they are over the age of 14 and determined a Mature Minor (see below).

Substance Abuse– Any young people 13 or older may provide consent for themselves for outpatient chemical dependency treatment services by a licensed provider. Anyone under 18 requires parental consent  to be admitted to an inpatient chemical dependency treatment program—unless the minor is determined to be a “child in need of services” under Washington law. If parents have not provided consent for their adolescent child’s care, they may not be liable for the cost.

Emergency Care — If a parent’s consent is not available, a minor can make their own medical decisions and provide consent in exigent circumstances.

Non-Emergency Care — In evaluating whether an individual under the age of 18 can provide their own consent for non-emergency medical treatment, providers must determine whether or not the minor is a “Mature Minor.” This status is based on their age, intelligence, maturity, experience, economic independence or lack thereof, general conduct as an adult, and freedom from the control of parents. In making this assessment, a health care provider is permitted to ask questions that elicit needed information. Because the notion of informed consent for health care requires more than simply indicating agreement, an individual must understand the nature of the medical condition and the treatment or procedure, as well as its implications.

Note: Effect of marriage or emancipation — If you’re under 18 but married to someone over 18—or legally emancipated (a rarity in Washington)—you’re not viewed as a minor in the eyes of the law; you’re legally authorized to make your own health care decisions and provide consent in all situations.

As a rule, health care providers will typically encourage teens to seek the input of parents or other responsible adults in their lives, but they also recognize the youth’s rights. Parents may not always agree with the choices teens make in health care circumstances, but this does not create liability on the part of the provider.

If you have questions about your legal rights as either a teen or a parent regarding your health care, you may want to talk to an attorney who practices in the realm of consumer health law, young adult rights, or health care advocacy.

For more information on this area of law, see our overviews of health care law and estate planning.