How do California consent rules work for minors and patients with impaired capacity?

High-yield California rules for this topic

Consent — competent adults

Cobbs v. Grant (1972) sets the material-risk standard — disclose what a reasonable patient would find significant: diagnosis, recommended treatment, material risks, expected benefits, reasonable alternatives, and the result of no treatment.¹ Truman v. Thomas (1980) extends the duty to informed refusal (explain the risks of declining, not just record the "no"), while Arato v. Avedon (1993) confirms disclosure is targeted, not a data dump.^{2 3} Performing a substantially different procedure than consented to is battery; consented procedure with inadequate risk disclosure is negligence.¹ The narrow emergency exception applies only when treatment is immediate, the patient lacks capacity, no surrogate is reasonably available, and delay would materially raise the risk of serious harm.⁴

Memorize it: "DR. ABCN" — Diagnosis, Risks, Alternatives, Benefits, Consequences of No-treatment (the Cobbs/Truman core disclosure set).

Consent — minors

Default rule: a minor's parent or guardian consents, with narrow exceptions under Family Code §6920 et seq.⁵ Three alternate lanes: a self-sufficient minor age 15 or older living apart from parents and managing their own finances (§6922, often with notice-to-parent duties); an emancipated minor consenting as an adult (§7002 and §7050); and a relative caregiver who completes the Caregiver's Authorization Affidavit when parents are unavailable (§6550).^{5 6} Good-faith reliance on the affidavit gives the provider civil and criminal immunity, but a parent's contrary wishes immediately override the caregiver.⁶

Memorize it: "15-Self / Emancipated / Caregiver-Affidavit" — three minor-consent lanes beyond the default parent-consent rule.

Consent — cognitively impaired adults

An adult who lacks capacity needs a lawful surrogate, not the most convenient relative, under the strict hierarchy in Probate Code §§4683, 4711, and 4712 — and a spouse has no automatic top authority if a higher lawful designation exists.⁴ Assembly Bill 2338 adds a default-surrogate framework of set family priorities when there is no advance directive or named agent.⁴ The dentist may stabilize without surrogate consent only when treatment is immediately needed, no surrogate is reasonably available, and delay creates serious risk of harm.⁴

Memorize it: "Recorded → Agent → Conservator → Default-Surrogate (AB 2338)" — the four lanes for adults lacking capacity.

Footnotes

1. A49 Cobbs v. Grant, 8 Cal.3d 229 (1972) — patient-centered material-risk informed-consent standard. https://scocal.stanford.edu/opinion/cobbs-v-grant-30236 ↩ ↩²

2. A50 Truman v. Thomas, 27 Cal.3d 285 (1980) — duty to disclose material risks of refusing recommended treatment. https://scocal.stanford.edu/opinion/truman-v-thomas-30565 ↩

3. A51 Arato v. Avedon, 5 Cal.4th 1172 (1993) — limits and context for the informed-consent disclosure analysis. https://scocal.stanford.edu/opinion/arato-v-avedon-31521 ↩

4. A52 California Probate Code §§4683, 4711, 4712, plus AB 2338 default-surrogate framework for adults lacking capacity. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB&sectionNum=4683. ↩ ↩² ↩³ ↩⁴

5. A27 California Family Code §§6922 (self-sufficient minor), 7002/7050 (emancipated minor) — minor self-consent statutes. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM&sectionNum=6922. ↩ ↩²

6. A57 California Family Code §6550 — Caregiver's Authorization Affidavit for relative caregivers (good-faith reliance immunity; parent contrary wishes override). https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM&sectionNum=6550. ↩ ↩²