"Maybe I Should Have Gone to Law School…"
One of the unfortunate realities of practicing child and adolescent psychiatry is the complex legal overlay that affects the practice. In particular, a C&A psychiatrist must have a good understanding of state law related to consent to treatment and release of patient information.
Any C&AP practitioner knows that the children of divorce often become “hostages” to the parents’ hostility to each other. In general, the custody order will spell out both parents’ rights in terms of consent and access to information, and the psychiatrist should review the legal custody documents. But is that enough?
Custody arrangements can change, sometimes for mundane reasons and at other times for very serious reasons. Just as informed consent is not an event, but a process, we recommend that psychiatrists treating children of divorced parents regularly review whether the adult they think has the right to consent on behalf of the child actually does have the right. Further, even if the custodial parent does have the sole right to consent on the child’s behalf, it may not be appropriate to leave the non-custodial parent out of the equation. After all, it is somewhat unusual for one divorced parent to have sole custody; the child will likely be spending time with the non-custodial parent on weekends, during the holidays, or during school vacations. It is essential that the non-custodial parent understand what medications the child is taking, what side effects can be expected, and how the parent with temporary custody should react if/when side effects become manifest. You don’t want to become yet another hostage of divorced parents. If you’re insured through The Psychiatrists’ Program, PRMS can provide you with some guidance on how to be sure you’re getting consent from the appropriate parent or guardian for a child. Contact our Risk Management Consultation Service.