Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, MI.
Departments of Emergency Medicine and Pediatrics, University of California, San Diego School of Medicine, San Diego, CA.
Ann Emerg Med. 2018 Feb;71(2):225-232. doi: 10.1016/j.annemergmed.2017.06.039. Epub 2017 Aug 11.
Many patients under the age of majority present to emergency departments (EDs) without parents or guardians. This may create concern in regard to evaluation of these patients without formal consent to treat. The Emergency Medical Treatment and Labor Act mandates that all patients presenting to EDs receive a medical screening examination and does not exclude these minors. Standards for who can provide consent for a patient vary from state to state and address important issues such as consent by parent surrogates, as well as adolescent emancipation, reproductive health, mental health, and substance use. This document addresses current federal and state legal implications of providing emergency care to minors, as well as guidance in obtaining consent, maintaining confidentiality, and addressing refusal of care.
许多未成年患者在没有父母或监护人的情况下前往急诊科(ED)。这可能会引起人们的关注,因为在没有正式同意治疗的情况下对这些患者进行评估。《紧急医疗救治和劳动法》要求所有前往急诊科的患者都接受医疗筛查检查,并不排除这些未成年人。各州对谁可以为患者提供同意的标准各不相同,涉及到重要问题,如父母代理人的同意,以及青少年的解放、生殖健康、心理健康和物质使用。本文件讨论了向未成年人提供紧急护理的当前联邦和州法律影响,并提供了获得同意、保密和处理拒绝护理的指导。