Ethics & Law · patient case question
Who signs the informed consent for Patient B, the 5-year-old?
Patient case: Consent Across Three Patients
Patient: 39-year-old male, plus two additional patients seen the same day
Chief Complaint: “My wisdom tooth on the bottom left is broken down and I want it out.”
Background: Patient A: 39-year-old male, healthy, no medications, no anticoagulant or antiplatelet therapy, no allergies. Tooth #17 grossly carious and non-restorable. Risks, benefits, and alternatives to extraction were discussed in full; he asked questions, expressed understanding, verbally agreed, and signed the consent form. Patient B: 5-year-old male attending with his mother for restorative treatment. Patient C: 44-year-old male rendered legally incompetent following a gunshot injury to the head; his wife has been appointed his legal guardian by the court.
Medications: Patient A: none
Vital Signs: Patient A: BP 120/76 mmHg · HR 72 bpm · RR 16 · T 98.6°F
Findings: Patient A: #17 with gross distal caries extending subgingivally, non-restorable. No pericoronitis, no trismus, no lymphadenopathy.
Show answer and explanation
Correct answer: D. His mother, as parent and legal guardian
- A. Incorrect. A witness attests that the signature was made; a witness does not authorize treatment.
- B. Incorrect. Consent is always required. The only question is who holds the authority to give it.
- C. Incorrect. A 5-year-old lacks legal capacity to consent. His assent is valuable and should be sought, but it carries no legal weight.
- D. Correct. A minor cannot provide legal consent, so a parent or legal guardian must consent on the child’s behalf. Good practice adds assent from the child — an age-appropriate explanation and agreement — alongside the parent’s legal consent.
Note: Recognized exceptions to parental consent vary by jurisdiction and typically include emancipated minors, married minors, and specific categories of care such as pregnancy or substance use treatment. True emergencies also permit treatment without prior consent.