Your child needs surgery. Or perhaps your co-parent wants your child to begin psychological or psychiatric treatment.
Then you learn that a decision has already been made, and nobody asked you. For divorced or separated parents, this raises an immediate question: Can my ex make major medical decisions for our child without my agreement?
In Texas, the answer depends largely on what your custody order says.
Being Joint Managing Conservators does not necessarily mean parents have equal authority over every medical decision. Texas courts can allocate important medical rights exclusively to one parent, jointly between the parents, or independently to each parent.
Start With Your Court Order
This is the most important point. Don’t assume that because you and your ex are Joint Managing Conservators, every medical decision requires both parents to agree. A Texas custody order should spell out which parent has the authority to make different decisions for the child. For major medical issues, look specifically for language addressing the right to consent to: Medical, dental, and surgical treatment involving invasive procedures and Psychiatric and psychological treatment.
Those rights may be allocated differently in different orders. They may be exercised exclusively by one parent, independently by either parent, or subject to the agreement of both parents.
That means two families who are both operating under a “Joint Managing Conservatorship” can have very different decision-making arrangements.
What Counts as a Major Medical Decision?
Texas custody orders commonly distinguish between ordinary medical care and treatment involving an invasive procedure. During a parent’s period of possession, unless the court order provides otherwise, that parent generally has the right to consent to medical and dental care not involving an invasive procedure. That allows parents to handle many routine healthcare needs while the child is with them without obtaining the other parent’s permission for every doctor’s visit.
Major decisions can be different. Depending on the circumstances, issues may arise involving things such as:
- Surgery
- Other invasive medical procedures
- Significant dental procedures
- Psychiatric treatment
- Psychological treatment
Before assuming that either parent can make one of those decisions alone, read the actual rights allocated in your order.
What If We Have to Agree?
Some custody orders provide that certain medical decisions are subject to the agreement of the other parent. In that situation, one parent generally should not simply make the decision unilaterally because the parents disagree. Ideally, the parents can discuss the recommendation, obtain information from the child’s healthcare provider, and reach an agreement.
But what happens when they can’t? That is where things can become difficult.
What Happens When Parents Disagree About Medical Treatment?
Imagine one parent believes a child needs a particular treatment and the other strongly disagrees. The disagreement could involve:
- Whether surgery is necessary
- Which doctor should treat the child
- Whether to pursue a particular course of treatment
- Whether psychological treatment is appropriate
- Whether psychiatric treatment is appropriate
- Competing recommendations from healthcare providers
The first step is usually to look at exactly how the court order allocates decision-making authority. If one parent has the exclusive right, that may resolve who has the authority to make the decision. If the decision must be made jointly, neither parent’s preference automatically controls simply because they feel more strongly about it.
Depending on the order and circumstances, parents may attempt to resolve the dispute through communication, additional medical opinions, parenting facilitation, mediation, or another dispute-resolution process.
When an important decision cannot be resolved and the child’s health is at stake, court intervention may ultimately become necessary.
Do I Still Have a Right to Know What’s Going On?
Usually, yes, unless your rights have been limited by the court.
Texas law provides that a parent appointed as a conservator generally has rights at all times to receive information from the other conservator concerning the child’s health, education, and welfare; access the child’s medical, dental, and psychological records; and consult with the child’s physician, dentist, or psychologist. The law also gives a parent the right to confer with the other parent, to the extent possible, before decisions concerning the child’s health, education, and welfare are made.
That distinction is important.
The right to receive information about your child’s healthcare is not necessarily the same as the right to make the ultimate medical decision.
A parent may have access to records and doctors even when the other parent has exclusive authority over a particular decision.
Can I Talk Directly to My Child’s Doctor?
Generally, a parent appointed as a conservator has the right to consult with the child’s physician, dentist, or psychologist unless the court has limited that right. That means parents should not necessarily have to rely entirely on their ex to explain what the doctor said. When an important medical decision is being considered, obtaining information directly from the healthcare professional can also help reduce misunderstandings.
What About Emergencies?
Emergencies are different. Texas law generally gives a parent appointed as a conservator the right, unless limited by court order, to consent to medical, dental, and surgical treatment during an emergency involving an immediate danger to the health and safety of the child.
That makes practical sense. If your child is seriously injured while with you, the law does not ordinarily require you to delay emergency treatment while attempting to locate the other parent. The priority is getting the child necessary care. Of course, the other parent should be informed as soon as reasonably possible.
What About Therapy and Mental Health Treatment?
This is an area where parents should pay particularly close attention to their orders.
Texas law separately identifies the right to consent to psychiatric and psychological treatment, and that right can be specifically allocated in the custody order. A sole managing conservator generally receives that exclusive right unless the court limits it, while orders appointing Joint Managing Conservators can allocate the right differently.
So don’t assume that the rules governing a routine pediatrician appointment necessarily answer whether one parent can unilaterally place a child into psychological or psychiatric treatment.
Check the order.
What If My Ex Makes the Decision Anyway?
Suppose your order requires joint agreement for a particular medical decision, but your ex proceeds without consulting you. Don’t automatically respond by doing the opposite.
Instead:
Document what happened
save relevant emails, text messages, medical records, appointment information, and communications with the provider.
Read your order carefully
make sure the particular decision actually falls within a right that requires your agreement.
Get the facts from the healthcare provider
if you have the right to access records and consult with the provider, understand what treatment was recommended and why.
Talk with your family law attorney
depending on the seriousness of the issue and the language of the order, your attorney can help determine whether the situation warrants communication with the other parent, mediation, enforcement, modification, or more immediate court intervention.
Can Medical Decision-Making Rights Be Changed?
Potentially. Sometimes an arrangement that worked when a child was young stops working as the child’s medical needs become more complicated. In other cases, repeated conflict over healthcare decisions may reveal that the existing allocation of rights is no longer workable.
Whether a Texas custody order can be modified depends on the applicable legal requirements and the facts of the particular case. A disagreement over one doctor’s appointment does not automatically mean the order needs to change. But repeated inability to make important healthcare decisions may be something worth discussing with an attorney.
Don’t Put the Child in the Middle
Medical disagreements can become emotional very quickly.
But avoid asking your child to decide:
- “Do you want to go to therapy?”
- “Do you think you need this surgery?”
- “Tell your dad you don’t want to take that medication.”
Children can certainly have thoughts and feelings about their healthcare, and depending on their age and circumstances those views may be important. But they should not be made responsible for resolving a legal dispute between their parents. The adults need to handle the adult decisions.
Final Thoughts
So, can your ex make a major medical decision for your child without you?
Maybe—but not simply because your ex is the other parent.
The answer depends on the type of medical decision and, most importantly, how your Texas custody order allocates that particular parental right.
Some rights may belong exclusively to one parent. Others may require agreement. Others may be exercised independently. Routine medical care during possession and emergency treatment are treated differently from certain major healthcare decisions.
When in doubt, don’t rely on what a friend, your ex, or even a healthcare provider thinks your custody arrangement means.
Read the order.
The language in that document is what matters.
Questions About Medical Decisions and Child Custody?
Disagreements over medical treatment, therapy, surgery, and other healthcare decisions can become some of the most difficult issues co-parents face. At Grinke Stewart Family Law, we help Texas parents understand the rights contained in their custody orders and navigate disputes involving important decisions affecting their children.
If you and your co-parent disagree about your child’s medical care, or you’re unsure who actually has the authority to make a particular decision, understanding your order is the first step.
