Legal question POA

Nurses General Nursing

Updated:   Published

Specializes in orthopedic/trauma, Informatics, diabetes.

There is a big story going on here in NC about a mom who cannot make decisions for her 18 year old son because he does not have a HCPOA.

When my son turned 14, I do not have access to all parts of his MyChart (all the Epic versions have this). Of course I have access to the bill pay part LOL

He is a minor and cannot have a HCPOA, as far as I know. He seems to be in a no-mans land. Tell me I still have the right to make medical decisions for him and if I do not have access to his medical records anymore, how does that work?

At what age can they have a HCPOA?

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Specializes in Critical Care.

An 18 year old is an adult and legally capable of making their own decisions. In many states, the legal age for medical decision making is younger than 18, so a parent can't override a 16 year olds' medical decisions if that state defines 16 year olds as able to make their own medical decisions. What story are you referring to?

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It depends on the situation and his capacity to understand it. It depend on where you are I guess. But in NZ, Australia, UK and a few others if the child is deemed "Gillick"Competent then they can make their own decisions in regards to health treatment.

Basically if they are able to understand what they are doing/is going to happen and the consequences of that, then they are deemed competent to make decisions.

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Specializes in Healthcare risk management and liability.

This issue is heavily dependent on the unique statutory, regulatory and case law of a given jurisdiction. What people may quote as the practice in their state will likely be different in North Carolina. Generally speaking, as the biological or adoptive parent, you still have the right to make medical decisions on most areas of treatment on behalf of your 14 year old. There are certain areas of treatment that only a minor can consent to in most states, and those areas usually have to do with treatment for sexual, substance use or behavioral health matters. You cannot access those areas of the medical record nor approve/deny treatment in those areas without the consent of your child. You are still probably legally obligated to pay the bills for those areas of treatment, however. In terms of a healthcare POA, you generally have to be of legal capacity to execute such a document, which means you are over 18 or legally emancipated if under the age of 18.

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mmc51264 said:
There is a big story going on here in NC about a mom who cannot make decisions for her 18 year old son because he does not have a HCPOA.

Of course not, because 18 is legally an adult. Even if he completed an HCPOA document naming her his POA for healthcare decisions, that would not be in effect unless he were incapacitated in some way and unable to make or communicate his own decisions at the time. She would still be unable to overrule his decisions unless he were incapacitated.

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Specializes in Acute Care Pediatrics.

The parts of the chart you can't see at 14 are the parts related to sex, substance abuse, and mental health. There are protections in place to protect children.

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Specializes in orthopedic/trauma, Informatics, diabetes.

I understand that as an 18 year old, they make their own decisions, what I am curious is when does HCPOA come into play when the child is in a state that he/she is unable to make any decisions.

As far as my 14 year old, I can see NOTHING other than billing. Not even his vaccinations anymore. I am all about him having his privacy, but I want to know when I can/need to have something in place in case he is incapacitated. My younger son is a Type 1 diabetic and there are some pretty important things that could go wrong and we would like to be prepared when he becomes of age.

I can ask a lawyer here in NC about our statutes so that is my child goes into DKA when he is 15, that we have some say in his care. No parent handbook on this topic!!

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Specializes in Healthcare risk management and liability.

I did some Googling and found this article on the state of the law (as of April 2015) on consenting to healthcare for minor children in North Carolina.

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mmc51264 said:

I understand that as an 18 year old, they make their own decisions, what I am curious is when does HCPOA come into play when the child is in a state that he/she is unable to make any decisions.

As far as my 14 year old, I can see NOTHING other than billing. Not even his vaccinations anymore. I am all about him having his privacy, but I want to know when I can/need to have something in place in case he is incapacitated. My younger son is a Type 1 diabetic and there are some pretty important things that could go wrong and we would like to be prepared when he becomes of age.

I can ask a lawyer here in NC about our statutes so that is my child goes into DKA when he is 15, that we have some say in his care. No parent handbook on this topic!!

Umm, you neglected to mention in the OP that you were talking about an 18 yo in a coma ... That's a pretty big piece of info to leave out.

As is so often the case here on AN, in the article, we only have the mother's side of the story. There may be other elements of the story that she left out that would make the situation more clear (why she wasn't automatically considered his next of kin and decision-maker).

I have spent most of my career and adult life in NC (although I'm not there now), and I do know there is a wrinkle in NC law that specifies that, in the absence of advanced directives or an established POA, next of kin cannot make the decision to terminate life-sustaining treatment on an individual who is unable to make her/his own decisions; they can make any other kind of medical decisions, but they can't choose to let the person die. I don't know if that would have anything to do with this mother's situation.

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Specializes in orthopedic/trauma, Informatics, diabetes.

I was just using this as an an example because it got me to thinking, as my children are getting older. Sorry I wasn't clear.

Thx Risk Manager for the link!!!!

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Specializes in Pedi.

The OP is a little misleading. This adult patient didn't have any sort of advanced directive or health care proxy. Because of that, parents had to go to court to get legal guardianship, which was granted. They were then able to make decisions on his behalf. This happened 5 years ago, the patient survived and is able to play the guitar and take college classes today.

Your child is a minor. If he needs surgery, you need to consent for him. He doesn't need a power of attorney, he is a minor and you are his legal guardian. There are some additional safeguards for adolescents as to what information their parents can access on their behalf. Those safeguards are in place to protect the teen, lest the abusive father find out that his 15 year old daughter has gonorrhea or something.

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