You find out after the fact that the other parent approved an important course of medical treatment for your child. A procedure has been scheduled without discussing it with you. Maybe a new medication has been prescribed, a specialist is involved, or you learn about a significant health decision only when your child mentions it.
If you share custody, it is understandable to wonder: Was the other parent allowed to make that decision without you?
In Pennsylvania, the answer depends largely on legal custody, what your custody order says, and the type of medical decision involved. Being granted more physical custody time does not necessarily give one parent the authority to make every important health care decision alone.
When a medical issue affects your child, understanding the difference between legal and physical custody can help you determine whether you had the right to be involved in the decision and what to do if disagreements continue.
What Does Legal Custody Have to Do With Medical Decisions?
Pennsylvania custody law separates legal custody from physical custody.
Physical custody concerns who has actual physical possession and care of the child. Legal custody concerns the authority to make major decisions on the child's behalf, including medical, educational, and religious decisions.
Legal and physical custody are separate parts of a custody arrangement, and they do not always belong to the same parent in the same way. If your order provides for shared legal custody, both parents have legal custody rights concerning major decisions affecting the child, subject to the terms of the custody order.
The starting point, therefore, is to identify how your order allocates legal custody and whether it contains any specific provisions addressing medical decisions.
Does Shared Legal Custody Mean Every Doctor's Appointment Requires Permission?
Not every health-related decision creates the same kind of custody issue.
Pennsylvania law defines legal custody in terms of major decisions. It does not turn every routine parenting choice or minor medical matter into a formal dispute between parents.
For example, taking a child for ordinary care when the child becomes sick can be very different from deciding that the child will undergo a significant procedure, begin ongoing treatment, or make a substantial change to an established treatment plan.
The facts matter, and so does the language of your order.
Some custody orders contain more specific provisions about medical care, communication, insurance, providers, or how parents are expected to handle disagreements. Those provisions can be particularly important when the parents already have a history of conflict over health care decisions.
Before assuming that the other parent violated your rights, review the actual order and consider the significance of the decision that was made.
What If the Other Parent Has Primary Physical Custody?
Primary physical custody and sole legal custody are not the same thing.
If your child lives primarily with the other parent, that parent naturally handles many parts of the child's day-to-day life. That does not necessarily mean the other parent has sole authority to decide significant medical issues.
If you share legal custody, your right to participate in major decisions does not disappear simply because the child spends fewer overnights with you.
The custody order, rather than the number of overnights alone, is what you should look to when determining who has authority over significant medical decisions.
What If Your Child Needs Care Right Away?
An urgent medical situation is different from an ordinary disagreement about planned care.
Pennsylvania law allows medical, dental, and health services to be provided to a minor without parental or guardian consent when, in the physician's judgment, trying to obtain consent would delay treatment and increase the risk to the child's life or health.
In a genuine emergency, getting the child necessary medical care comes first. A custody disagreement should not be allowed to delay treatment that cannot safely wait.
Communication between the parents can still matter. After a significant medical event, hospitalization, diagnosis, or treatment, review the custody order for any requirements about notifying the other parent or sharing information about the child's care.
The key is to distinguish a genuine need for immediate care from a nonemergency major decision that could reasonably have been addressed beforehand.
What If You Disagree About Therapy, Medication, or Other Treatment?
Medical disagreements can become especially difficult when both parents believe they are acting in the child's best interests. Disputes can involve medication, surgery, specialists, evaluations, ongoing treatment, or whether another medical opinion is needed.
Pennsylvania has separate consent rules for voluntary outpatient mental health treatment. A parent or legal guardian can authorize this type of care for a minor, while a child who is 14 or older can also consent without a parent's or guardian's approval.
Once consent has been validly given under these rules, someone else with consent rights generally cannot simply override it. That means disagreements involving counseling or therapy can raise issues beyond the parents' custody arrangement alone.
For other significant medical decisions, the custody order remains an important starting point. It identifies who has legal custody and may contain additional provisions about medical care, communication, or disagreements.
If you and the other parent disagree about treatment, focus first on what your child needs and what the medical provider is recommending. Make sure you understand why the treatment has been proposed, whether the decision needs to be made quickly, and whether other reasonable options have been discussed. Having that information can make it easier to identify what you actually disagree about and what needs to happen next.
When parents with shared legal custody cannot resolve a significant medical disagreement, Louis Wm. Martini, Jr., P.C. can review the custody order and the treatment at issue to help clarify each parent's decision-making rights and whether the disagreement needs to be addressed through the existing custody case.
Can You Get Your Child's Medical Records if the Other Parent Will Not Share Them?
If you have sole or shared legal custody, Pennsylvania law generally provides access to your child's medical and dental records, with exceptions for information that is independently protected from disclosure.
That means you do not necessarily have to depend on the other parent to explain what happened at an appointment. Getting accurate information directly from the provider can help you understand the diagnosis, recommendations, medications, appointments, and next steps.
There are important confidentiality exceptions. Mental health records, in particular, are governed by separate Pennsylvania rules.
When a minor independently consents to outpatient mental health treatment, the minor generally controls the release of those treatment records, subject to legal exceptions and other applicable state and federal requirements.
Still, a parent's lack of physical custody at the time of an appointment does not, by itself, eliminate the record-access rights that come with legal custody.
What If the Other Parent Keeps Making Major Medical Decisions Without You?
If you share legal custody and the other parent repeatedly makes significant medical decisions without involving you, consider documenting what happened rather than responding only through an angry text or argument.
Keep track of the decision, when you learned about it, relevant communications, provider information, and what the custody order says. You can also communicate clearly and in writing that you want to be involved in future major decisions.
If the problem continues, the existing custody order should be reviewed closely. Depending on what the order requires and what has happened, the issue could involve enforcement of the existing order or a request to modify legal custody or other custody terms in the child's best interests.
The appropriate response depends on the specific decision, the language of the order, the parents' history of communication, and whether the problem is isolated or part of a continuing pattern.
Know What Your Custody Order Actually Gives You the Right to Decide
When parents are separated, medical decisions can become emotionally charged very quickly. You want to know what is happening with your child, understand the treatment being recommended, and have a meaningful role in important decisions.
Pennsylvania custody law recognizes a difference between parenting time and decision-making authority. If you share legal custody, having less physical custody does not automatically exclude you from significant medical decisions.
At Louis Wm. Martini, Jr., P.C., we help parents understand what their custody orders require and how Pennsylvania law applies when disagreements develop over a child's care. We can review the existing order, the medical decision at issue, and what has happened between the parents to help determine the appropriate next step.
If you are concerned that the other parent is making major medical decisions without involving you, contact our Media office to discuss your custody situation. We represent parents in Delaware County, Chester County, Montgomery County, and throughout Southeast Pennsylvania.
To get started, use our contact form to schedule your free initial consultation.
Disclaimer: Every custody matter depends on its particular facts and legal circumstances. The articles on this blog are for informational purposes only and are no substitute for legal advice or an attorney-client relationship. If you are seeking legal advice, please contact our law firm directly.