Medical decision making
When a child turns 18 years old, they are an adult. The 18-year-old (young adult) has the right to make medical decisions that their parents or guardians used to make. The doctors and clinic staff must talk directly to the young adult about their needs, care, and choices. The young adult must sign the consent forms for treatment. They choose what health information they will share and what will stay private with the doctor. They also choose who can have the information and who can be involved in their care. They must sign the release forms to share information.
The Health Insurance Portability and Accountability Act (HIPAA) is a law that protects medical records and health information sharing. Doctors and staff must follow the law to protect your privacy. The information is called protected health information, or PHI. It includes medical conditions, mental health, test results, health insurance, or other things about your care.
A young adult may become too sick or injured to make their own medical decisions. Some may not be able to make decisions at any time. The parent or guardian may need a legal tool to be involved in the young adult’s care or to make medical decisions for the young adult.
Below are tips to help you plan for medical decision making in the future:
- Think about who will make medical decisions in the future.
- Talk with your health care team or social worker about options.
- Talk with a lawyer if you need advice about a tool for medical decision-making.
- If guardianship will be needed, talk with a lawyer at least 6 months before the child turns 18 years old.
Teens and young adults
Before the age of 18, your parents work with your health care team and make medical decisions for you. On your 18th birthday, you become an adult. As an adult, you will work with your health care team and be in charge of making decisions about your health care.
As an adult you will need to become familiar with the documents that you will need to sign. Below is information about the documents you will be signing.
- Sign a consent for medical treatment. This consent gives your health care team the permission to care for you and share your health information, or PHI, with others who are involved in your health care.
- Decide if you want your family members or friends to know your health information. Your health information is protected and private under the HIPAA privacy rule. If you want your health care team to share your health information with your family members or friends, you will sign a release of information.
- Sign an advanced directive about your future care. If you are interested in information about advanced directives, ask your health care team, social worker, or chaplain.
Parents and caregivers
On your teen’s 18th birthday, they become an adult. As an adult, they will begin to work with their health care team and be in charge of making decisions about their health care. Your young adult will sign a consent for medical treatment and decide who their health care team to share their health information, or PHI, with.
Your young adult will also sign a release of information. This release lets the health care team know who they can share your young adult’s health information with. Without your young adult’s permission, Children’s Health is not allowed to share your health care information with you.
Not all young adults will be able to make medical decisions for themselves. In these cases, assistance in decision making may be needed. Types of assistance can include medical power of attorney, guardianship, or supported decision-making agreement. Talk with your health care team or social worker if your teen will need assistance in decision making when they are an adult.
Helpful terms to know
- Consent for treatment:
- Giving your health care team permission to treat you.
- Giving your health care team permission to share your health information as needed for treatment purposes.
- Giving your health care team permission to share your health information with others.
- Acknowledging that you will be responsible for payment of the treatment provided.
- PHI (Protected Health Information): Information you provide to your health care team, or that is created or received about your health care. Examples of PHI can include your name, address, telephone number, email address, medical record number, and social security number.
- Release of information: Giving your health care team permission to share your health information with your family or others.
- Advanced directives: Legal documents that allow you to make decisions about treatment and end-of-life if you should become too ill or hurt to express your wishes.
- Medical power of attorney: This document gives the person who you choose (your agent) the legal power to make health care decisions for you. You can explain what your wishes are in the documents. Your agent can only make the decisions when you are not able to make them yourself.
- Guardianship: A person (guardian) appointed by a judge in a court case to be the supervisor or administrator for an incapacitated person (ward). The guardian makes decisions for the ward and reports to the court each year.
- Supported decision making agreement: A disabled adult can execute this to name “supporter” to help them get information they need to make an informed decision, understand options/risks, and communicate the decision to others. The supporter does not make the decision for the adult. The disabled adult can end it at any time.
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