Informed consent for minors: who signs

Who signs informed consent for minors? Under Spain's Law 41/2002 on patient autonomy, if the minor is over 16 or emancipated, they consent themselves, except in an action involving serious risk. If they are not intellectually or emotionally able to understand the scope of the intervention, their legal representative consents, after hearing the minor's opinion.

What the law says, case by case

The answer depends on the minor's age and their ability to understand the intervention. The rule is in article 9 of Law 41/2002, the basic law on patient autonomy in Spain, which regulates consent by representation. For a patient who is a minor, it distinguishes these situations:

The minor's situation	Who consents	Where
Not intellectually or emotionally able to understand the scope of the intervention	Their legal representative, after hearing the minor's opinion	Article 9, paragraph 3, letter c
Is an emancipated minor or over 16	The minor themselves: consent by representation is not possible	Article 9, paragraph 4
An action involving serious risk to their life or health, in the doctor's judgement	Their legal representative, once the minor's opinion has been heard and taken into account	Article 9, paragraph 4
Clinical trials and assisted human reproduction techniques	Governed by the general rules on the age of majority and by their own special provisions	Article 9, paragraph 5

The age-16 rule has a limit: it does not apply to a minor who is unable to understand the scope of the intervention, nor to someone whose capacity has been modified by a court, where the ruling says so. In those two cases consent is given by representation even if the person has turned 16.

Below the age of 16, the law ties consent by representation to the minor not being intellectually or emotionally able to understand the scope of the intervention. Assessing that capacity in each case is a clinical decision, not an administrative one; if in doubt, consult your adviser before the intervention.

Two more rules apply in every situation. The representative's decision must always be taken with the patient's greatest benefit to life or health in mind, and decisions contrary to those interests must be brought to the attention of the judicial authority, directly or through the Public Prosecutor's Office, unless urgency makes it impossible to obtain judicial authorisation. And representation must be appropriate to the circumstances and proportionate to the needs to be met: the patient will take part in decision-making as far as possible.

Hearing the minor, even when someone else signs

Even when the representative signs, the minor's opinion counts. Article 9 of Law 41/2002 requires the legal representative to give consent after hearing the minor's opinion, in accordance with article 9 of Organic Law 1/1996 on the Legal Protection of Minors.

That organic law recognises the minor's right to be heard and listened to, with their opinions given due weight according to their age and maturity, and to receive the information they need to exercise that right in language they can understand and adapted to their circumstances. So that they can exercise it themselves, it considers that they have sufficient maturity in any case once they have turned twelve.

In the consultation room, this comes down to two simple things: explain the intervention in words they understand and record that they have been heard. If the minor disagrees, record that too, and make sure the professional knows before starting.

Do both parents have to sign?

Not necessarily. The Spanish Civil Code says that parental authority is exercised jointly by both parents, or by one with the express or tacit consent of the other, and that acts carried out by one of them in line with social custom and the circumstances, or in situations of urgent necessity, are valid.

If only the parent accompanying the minor signs, record who they are and their relationship to the patient. And when the parents are separated, a court ruling divides the decisions between them, or you know they disagree, do not settle it at the front desk: ask for the relevant documentation and consult your adviser before starting the treatment.

Their data follows another law and another age

Consent to process a minor's personal data does not follow the age-16 rule. The LOPDGDD (Spain's data protection law) says that the processing of a minor's personal data may be based on their consent only when they are over fourteen; for children under fourteen, processing based on consent is lawful only if the consent of the holder of parental authority or guardianship is recorded. The law itself makes an exception for cases where it requires the assistance of the holders of parental authority or guardianship for the act in the context of which consent is collected.

Note the words “may be based”: that age matters when the data processing relies on consent. For attending the patient, the basis for processing their health data is a different one, healthcare provision, as we explain in informed consent and data protection. It does count in uses such as sending advertising. Photos of a minor also have their own image rules, which we cover in before-and-after patient photos.

What is being decided	Reference age	Rule
Consenting to a healthcare action	Over 16 or emancipated, with the exceptions above	Law 41/2002, article 9
Being heard in their own right	Twelve, in any case	Organic Law 1/1996, article 9
Consenting to the processing of their data, when it is based on consent	Over fourteen	LOPDGDD, article 7
Ceasing to be a minor	Eighteen	Civil Code, article 240

How to organise it at reception

With minors, who signs is settled before the patient goes in to the consultation. This checklist puts it in order:

1. Record the legal guardian from registration, with their name, their relationship to the minor and a telephone number.
2. Check who is accompanying the minor on the day of the treatment and, if it is not the person on record, clarify in what capacity they have come.
3. Make the document say who signs and why: the minor themselves, or their legal representative on the minor's behalf.
4. Record that the minor has been heard when their representative signs.
5. Keep the papers separate: the treatment consent, the authorisation for advertising and the one for photos, each in its own document.
6. Review the record on the birthdays that change the rules: at 16, as a general rule, the patient consents themselves, and at 18 they stop being a minor.

We go through what else the document must contain in what an informed consent form must include.

How Mi Clínica handles it

Mi Clínica does not decide who has to sign: the professional and the clinic assess that, with the law in hand. What the software does is keep the information in view and make the document say who signs:

• Guardian at registration. If the date of birth shows the patient is a minor, the software asks for the name of their legal guardian and does not save the registration without it.
• Alert on the record. The minor's record carries the “Menor” (Minor) alert with the name of their legal guardian and, if recorded, their relationship to the patient.
• No merged records. If the minor shares a telephone number or email with their mother or father, the software warns that there are similar patients and does not merge them: whoever registers the patient decides.
• Who signs, in the document. When preparing a document you write who signs: the patient or their legal guardian. If that field says they sign as legal guardian, the standard consent text states that they sign as the patient's legal guardian, and the signature box is the patient's or guardian's.

One detail worth knowing: the “Menor” alert is based on the age of majority, 18. The software does not apply on its own the age-16 rule of Law 41/2002 or the age-fourteen rule of the LOPDGDD. How documents and signing work is summarised on the Mi Clínica page (in Spanish).

Sources consulted

Checked on 11 October 2026. We link to the original source so that you can consult the current text.

• Ley 41/2002, básica reguladora de la autonomía del paciente y de derechos y obligaciones en materia de información y documentación clínica (texto consolidado). BOE.
• Ley Orgánica 1/1996, de Protección Jurídica del Menor (texto consolidado). BOE.
• Código Civil (texto consolidado). BOE.
• Ley Orgánica 3/2018, de Protección de Datos Personales y garantía de los derechos digitales (texto consolidado). BOE.
• Reglamento (UE) 2016/679, Reglamento general de protección de datos. BOE (DOUE).