In most countries there is an age when young people become legal adults. In the United States the natural guardianship of parents ends when children reach age 18. When the young person reaches 18 years of age, parents no longer have the legal right to make decisions and sign consent forms for their child or to see their child's medical record, unless the young person is in agreement. The health care professional must address this directly with the young person. In cases where the intellectual capacity of the young person is such that a legal guardian needs to be appointed, the parents submit an application for guardianship through the court system. In the United States, two pre-requisites should exist before a court appoints a guardian: (i) young people must be incompetent in at least one important area of their lives, such as health care decisions or financial matters; and (ii) there must be a present need for the guardianship.
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