Why St. Jude Needs Legal Papers for Medical Care

St. Jude staff must make sure they have permission to treat your child. Consent (permission) can come from:

• Parent who has legal custody
• Guardian
• Legal custodian
• Power of attorney holder for health care
• Other legal representatives appointed by the court or a state agency
• Health care surrogate or agent

St. Jude may ask for legal papers because they show that the person who gives consent can legally do so.

When St. Jude needs legal papers

St. Jude needs legal papers in these cases:

• If your child is under 18 and registers at St. Jude for the first time
• If there is a change in your child’s family, such as:
  • Divorce
  • Adoption
  • New custody arrangement
  • A new court order has been issued
• When parents are not married to each other or were not married when the patient was born
• When someone who is not a parent needs to consent
• When an adoption is not final, but the adopting parent has the right to consent from:
  • The court
  • Biological parent
  • Guardian

If these sound like your situation, bring legal papers when your child registers or returns to St. Jude. This helps your child get to appointments on time.

The St. Jude staff might also need to ask for legal papers in other situations that are unique to certain families.

It is best to bring all legal papers with you just in case.

Legal papers to bring

Bring the most recent papers that clearly show who can make decisions and give consent for medical treatment. The most common papers showing this are:

• A parenting plan giving legal custody, signed by a judge or chancellor
• A court order giving legal custody
• A court order appointing a guardian or conservator for a child younger than 18 or an adult
• A limited power of attorney to care for a child under 18
• Court orders that show who is not allowed to make legal decisions
• Protective and no-contact orders

A request to the court (often called a "petition") is not enough to authorize someone to give consent. You need:

• Parenting plan
• Court order
• Power of attorney
• Other documents

Consent for medical treatment of children in Tennessee

People who can give consent for medical treatment include the following:

• A mother, including an adoptive mother if the adoption is final.
• A father, if married to the mother when the child was born or if he has legal custody or legal authority to provide consent. This includes an adoptive father if the adoption is final.
  
• A person with a court order for legal custody or guardianship (depending on what the order says).
• A person with power of attorney for a child younger than 18 or an adult, if the power of attorney meets legal requirements.
• A child who is married, in the military, or has been given adult status by a court with the signed court order (an “emancipated minor”).
  

When parents are not married

According to Tennessee law, a child’s mother has custody when the parents are not married. This is true even if:

• The child was born somewhere else
• The child’s father’s name is on their birth certificate
• The father has an order of paternity
• The father is the one who takes care of the child

The child’s father may give consent only when:

• There is an emergency and the person with custody is not available
• A court has given the father has been given legal custody
• A court has given the father the right to consent to medical treatment
• The mother signed a power of attorney that gives the father the right to consent
• The father is in loco parentis

If parents are divorced or separated, the St. Jude staff must see papers showing who has legal custody. This is true even if the child has been a St. Jude patient for a long time.

When someone else gives consent

If someone who is not a parent wants or needs to give consent, that person needs legal papers showing the authority to do so. These papers can be:

• Court orders of legal custody or guardianship
• Limited power of attorney for care of a child younger than 18
• In loco parentis affidavit
• Similar legal documents

These documents are needed even if the person is a grandparent the child lives with or someone who is adopting the child (before the adoption is final).

If you do not have legal papers

If you do not have these legal papers with you, talk with your care team about it. There are other ways to get them to the hospital if you did not bring them with you.