# How do California consent rules work for minors and patients with impaired capacity? > Use this guide when you need the California consent framework for minors, surrogate decision-makers, and informed-consent duty. Last verified: 2026-06-10 Reviewed by: Mahtab Mansour, DDS on 2026-04-25 (re-verification in progress) ## Direct answer - Do not assume every parent, caregiver, or financially responsible adult can authorize every treatment decision. - California informed consent turns on material risks, alternatives, and the risks of no treatment, not just a signed form. - When capacity is impaired, the legal authority of the surrogate matters as much as the urgency of the care. ## Full guide ## 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.[^A49] *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.[^A50] [^A51] Performing a substantially different procedure than consented to is battery; consented procedure with inadequate risk disclosure is negligence.[^A49] 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.[^A52] **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.[^A27] 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).[^A27] [^A57] Good-faith reliance on the affidavit gives the provider civil and criminal immunity, but a parent's contrary wishes immediately override the caregiver.[^A57] **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.[^A52] Assembly Bill 2338 adds a default-surrogate framework of set family priorities when there is no advance directive or named agent.[^A52] 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.[^A52] **Memorize it:** **"Recorded → Agent → Conservator → Default-Surrogate (AB 2338)"** — the four lanes for adults lacking capacity. [^A7]: `A7` Dental Board of California — continuing education, renewal, and permit-maintenance guidance. [^A9]: `A9` California Health & Safety Code §123110 — patient inspection and copy timelines (still apply to telehealth records). [^A11]: `A11` California Business & Professions Code §2290.5 — telehealth consent and parity. [^A12]: `A12` Department of Consumer Affairs CURES overview. [^A13]: `A13` Department of Consumer Affairs CURES mandatory-consultation flyer and exemptions. [^A15]: `A15` California Business & Professions Code §§1625, 1680 (including §1680(z) seven-day written report for a patient death or removal to a hospital or emergency center), 1684.5, 1685 — definition of dentistry, unprofessional conduct, telehealth-supervision cap, delivery of dental care. [^A19]: `A19` Dental Board of California — current anesthesia and sedation permit framework (GA, MGA, MS, PMS, OCS-A). [^A20]: `A20` Dental Board of California, SB 1453 alert — anesthesia/sedation changes effective 1/1/2025 (MGA permit, pediatric endorsements, physical presence). [^A21]: `A21` California Business & Professions Code §651 — advertising rules, including disclosure of material limits on advertised fees. [^A24]: `A24` California Health & Safety Code §11158.1 (opioid counseling), §11159.2 (counseling for minors), and AB 2760 (naloxone co-prescribing). [^A27]: `A27` California Family Code §§6922 (self-sufficient minor), 7002/7050 (emancipated minor) — minor self-consent statutes. [^A28]: `A28` California Business & Professions Code §654.3 — patient financing and third-party credit arrangements. [^A29]: `A29` California Civil Code §51 (Unruh Civil Rights Act); Government Code §§7290–7299.8 (Dymally-Alatorre Bilingual Services Act); ADA Title III. [^A30]: `A30` California Business & Professions Code §1683.1 — telehealth provider identification disclosures. [^A31]: `A31` California Business & Professions Code §1683.2 — complaint-waiver prohibition. [^A32]: `A32` California Business & Professions Code §688 — electronic prescribing and exemptions. [^A37]: `A37` California Business & Professions Code §1700 — license, permit, and registration display. [^A39]: `A39` 16 CCR §1018.05 — 30-day reporting of criminal indictments and felony or misdemeanor convictions to the Board. [^A40]: `A40` California Business & Professions Code §1682 — anesthesia informed consent and pediatric warning language. [^A49]: `A49` *Cobbs v. Grant*, 8 Cal.3d 229 (1972) — patient-centered material-risk informed-consent standard. [^A50]: `A50` *Truman v. Thomas*, 27 Cal.3d 285 (1980) — duty to disclose material risks of refusing recommended treatment. [^A51]: `A51` *Arato v. Avedon*, 5 Cal.4th 1172 (1993) — limits and context for the informed-consent disclosure analysis. [^A52]: `A52` California Probate Code §§4683, 4711, 4712, plus AB 2338 default-surrogate framework for adults lacking capacity. [^A57]: `A57` California Family Code §6550 — Caregiver's Authorization Affidavit for relative caregivers (good-faith reliance immunity; parent contrary wishes override). [^A38]: `A38` California Business & Professions Code §1750 — dental assistant definition, basic supportive dental procedures, and infection-control prerequisites. [^A59]: `A59` Senate Bill 351 (2025) — prohibitions on private equity and hedge fund clinical interference. [^A60]: `A60` Assembly Bill 82 (2025); HSC §11165(k) — CURES reporting exemptions for testosterone and mifepristone. [^A61]: `A61` 16 CCR §1016 — continuing education repeating opioid course mandate. [^A62]: `A62` Dentist and Dental Hygienist Compact (DDHC) — member-state status (13 member states as of May 2026; California not a member; compact privileges not yet issued in any state). [^A63]: `A63` Assembly Bill 116 Health Omnibus — elimination of State-only Medi-Cal dental benefits for undocumented adults effective July 1, 2026. [^A73]: `A73` California Business & Professions Code §1647.31 — minimal sedation of a patient under age 13; PMS, GA, or pediatric-endorsed MS permit required. [^A80]: `A80` California Business & Professions Code §1647.2 (SB 501, operative 1/1/2022) — pediatric moderate-sedation requirements for patients under 13, including pediatric endorsement and pediatric life support (PALS or Board-approved equivalent) certification. ## Related guides - [What telehealth and patient-of-record rules apply in California dentistry?](https://dentovio.com/guide/california-dentistry-law-ethics-exam/scope-patient-of-record-telehealth/index.html.md) - [What are California dental records and confidentiality rules?](https://dentovio.com/guide/california-dentistry-law-ethics-exam/records-confidentiality/index.html.md) - [What changed in California dental sedation and anesthesia rules?](https://dentovio.com/guide/california-dentistry-law-ethics-exam/sedation-anesthesia/index.html.md)