Children

• Parents and legal guardians have the authority to refuse treatment for their children until a certain age. Once the child reaches the state determined age, they have an active voice in their treatment.
  
  

Mental Health Professionals

• Treatment refusal by a child or parent can create animosity between the physician and patient. The physician may seek to defend the clinical judgment and treatment suggestion.
  
  

Danger to Self

• The state has the authority to force hospitalization and/or treatment if the child is considered a danger to themselves or others.
  
  

Guidelines

• Assessment of competence should consider the youth's ability to understand the treatment and be able to make a choice, further understanding the consequences. They should be apprised of the risks and side-effects of the treatment and risks of refusing the treatment. Instruction on informed consent to treatment and discussion with the child and family regarding the purpose and benefits of the proposed treatment should be performed.
  
  

Considerations

• A youth that is competent will have supportive parents and trust their physician. They should be free from having any pressure applied or misguided information to impair judgment.