How Does Paternity Affect Medical Decisions?
Being a legal parent, not just a biological one, is what gives you authority to make medical decisions for your child. That authority matters most in the moments you least expect, when a child needs treatment and someone has to consent. The Law Office of Chad Foster helps Snohomish County families with parentage matters.
The Short Answer
Legal parentage is the key that unlocks a parent's authority to make health care decisions for a minor child. In Washington, a biological connection alone does not automatically place your name where it needs to be when a hospital asks who can consent. Legal parentage, established under the state's Uniform Parentage Act, chapter 26.26A RCW, is what the law and health care providers look to. Once you are a legal parent, you generally have the authority to make medical decisions for your minor child, and in certain later-life situations you may also serve as a decision-maker for an adult child who cannot decide for themselves.
Medical Decisions for a Minor Child
For most families, the everyday reality is straightforward: a legal parent consents to their minor child's medical care, from routine checkups to vaccinations to treatment in an emergency. Washington's informed consent statute reflects this. RCW 7.70.065 sets out who may provide informed consent for a patient who cannot consent on their own, and for a patient under the age of majority it lists, in order of priority, the people authorized to consent. Parents of the minor patient appear on that list under RCW 7.70.065(2)(a)(iii), positioned after a court-appointed guardian or legal custodian and certain court-authorized individuals.
The practical significance is easy to miss until it matters. When a child needs care and a parent's consent is required, the provider needs to know who counts as a parent. For a legal parent, that authority is generally clear. For someone who is biologically connected but never legally established as a parent, it can be far murkier, which is exactly the kind of uncertainty families want to avoid during a medical crisis. Establishing legal parentage in advance removes that question before it ever comes up.
The parenting plan or another court order may allocate or limit medical decision-making. Washington also permits minors to consent to certain care themselves. Legal parentage is therefore a starting point, not unrestricted authority over every treatment decision. When the surrogate-consent statute applies and several available people occupy the same priority class, its agreement requirements also matter. Medical decision-making should be read alongside parentage, custody, and visitation rights.
Why Establishing Parentage Comes First
Because the authority to consent flows from being a recognized parent, establishing parentage is the foundational step. Under chapter 26.26A RCW, unmarried parents commonly establish parentage through an acknowledgment of parentage under RCW 26.26A.200, signed by the woman who gave birth and the alleged genetic father, or through a court proceeding to adjudicate parentage under RCW 26.26A.400. Married spouses often benefit from the presumption of parentage in RCW 26.26A.115. Whichever path applies, the point is that legal parentage is what connects a biological relationship to real decision-making authority. A father who assumes his biological tie is enough may discover, at the hospital, that the paperwork tells a different story. An acknowledgment of parentage is one way legal parentage can be established.
Medical Decisions for an Adult Child
Ordinary parental decision-making authority ends when a child becomes an adult. A parent may later qualify as a surrogate under a separate statutory rule if the adult lacks capacity. An adult is generally presumed to make their own health care decisions. But if an adult child later lacks the capacity to make a health care decision, for example after a serious injury or illness, Washington law again looks to a priority list of people who may consent on that person's behalf.
Under RCW 7.70.065(1)(a), the ordered classes for an adult patient who cannot make a health care decision begin with a court-appointed guardian, then someone holding a durable power of attorney for health care, then the patient's spouse or state registered domestic partner, then adult children, and then parents of the patient. Parents appear in that hierarchy under RCW 7.70.065(1)(a)(v). In plain terms, if an incapacitated adult has no guardian, no health care power of attorney, no spouse, and no adult children available to decide, a parent may step in as the default surrogate decision-maker. That possibility rests on the parent being a legally recognized parent, which again traces back to parentage established under chapter 26.26A RCW.
It is worth noting that this statutory hierarchy is a default. Adults can plan ahead by naming a decision-maker through a durable power of attorney for health care, which sits near the top of the priority list and can override the default order. For many families, a combination of established parentage and thoughtful advance planning provides the most certainty.
What This Means for Snohomish County Families
For families in Snohomish County, the lesson is practical. Whether you are a new parent wanting to be sure you can consent to your baby's care, or a parent thinking ahead about an adult child with a disability, legal parentage is the thread that runs through both. It is not enough to be the biological parent in your own mind; the law and the health care system need a recognized legal relationship. Establishing that relationship early, and revisiting your planning as your child grows, spares your family from confusion at moments when clarity matters most.
Medical decision-making is one of the most concrete reasons parentage matters. It is easy to take for granted until the day it is tested, and by then the time to establish it has usually passed.
If you want to make sure your parental authority over your child's medical care is on solid legal footing, the Law Office of Chad Foster can help you establish parentage and plan ahead in Snohomish County.
Need help with a child custody or support matter in King or Snohomish County? Learn about our child custody and support services, or call 425.785.8679 for a consultation.