Who besides the patient is allowed to consent?
For children or others who are unable to make the decision for themselves, the parent or legal
guardian is legally responsible for getting the information, making the decision, and signing the
consent form. But that doesn’t mean that the child or patient who is not considered mentally
competent is always left out of the process. Some facilities require the assent of older children
before they go into a research study, even after the parents have agreed on the child’s behalf.
Assent means that, even though the parents sign the form, the child must also be OK with the plan
before the facility will do the treatment.
Along the same lines, people who are unable to manage their daily affairs because of impaired
thinking or emotional problems might still be able to understand the medical situation and make
their wishes known. They should be given information in a way they can understand, and asked
what they want to do.
In the event that you become unable to take in information and make your wishes known, another
person may be asked to take part in the process of informed consent. There are several ways that
person can be chosen.
Durable power of attorney for health care
The only way you can choose the person to make these decisions for you is to set up a durable
power of attorney for health care (also called a health care power of attorney). In this case, if you
are unable to speak for yourself, the person you chose becomes legally responsible for making
medical decisions on your behalf. This person is sometimes called your proxy, agent, or surrogate.
For more on health care powers of attorney, see our information, Advance Directives. (You can
read it on our website, or call us for a copy.)
Court-appointed proxy
Another option is a court-appointed surrogate or proxy. This is someone a judge chooses to make
medical decisions for you. If you become unable to make decisions for yourself, someone else –
such as the doctor, facility, a friend, or a family member – may ask (petition) the court to appoint
someone to do it for you. The process varies from state to state.
State family agency acts
Many states have passed family agency acts that choose which family members (in a listed order of
priority) may act on behalf of a person who cannot speak for her- or himself. This option may be
used if you don’t have an advance directive or court-appointed proxy. Depending on your family
situation and which state you are in, that person may be your legal guardian, spouse, parent, child,
sibling, or other relative.