The term "emancipation" refers to the legal ways in which a minor can gain independence from their parents and adult status for purposes of consent to medical care as well as handling their own legal affairs. All states provide for minors to become automatically emancipated from their parents at age 18. However, for some minors, their family or social situation puts them in a position in which it's preferable to handle their own affairs much earlier than age 18, and they may encounter EMS in situations where their legal status to consent for medical care comes into question.
Whether a minor is legally emancipated is a matter of state law, so it's important to know your own state's laws regarding emancipation. These state laws vary widely: from none at all to a set of circumstances short of a court automatically emancipating a minor.
For example, Indiana has no emancipation laws at all, and minors remain under parental control until they reach age 18. In California, to become emancipated before age 18, a minor must either be married with their parents' permission, be in the armed forces with their parents' permission or have received a declaration of emancipation from a court. This declaration of emancipation requires that the minor be at least 14 years of age, not want to live with their parents, have parental consent and demonstrate that they are employed and able to manage their own finances.
Other states, such as Texas, take a more conservative view by not recognizing emancipation except by court order. In Texas, a minor must be 16 years of age, living on their own and self-supporting in order to obtain emancipation from a court.
In Pennsylvania, in addition to emancipation by court order, a minor can be emancipated by marriage or active duty in the military. Pennsylvania also considers a minor temporarily emancipated if they're in law enforcement custody or in need of medical care and a parent or guardian cannot be located. The law makes specifically the parent or guardian responsible for the cost of medical care rendered under these circumstances.
The confusion for EMS providers often arises when they encounter a minor who is a mother, and they don't know whether that young mother can consent for her child to receive medical care. Many EMS providers erroneously believe that such mothers are somehow "medically emancipated" and can give consent for themselves as well as their babies. However, the answer to this question is generally "no" because having a child is not one of the legal circumstances under which any state recognizes automatic emancipation. In fact, a teen who has a baby is less likely to be able to support herself financially and probably less likely to be able to become emancipated.
In summary, a great deal of confusion in EMS surrounds the status of minors and their ability to consent for medical care. Without question, if a minor is in critical condition, treatment should be rendered and the patient transported to a hospital. The EMS service, the hospital, social workers and attorneys can sort out who is responsible for paying the bill later. More confounding situations arise when a minor patient's injuries are less severe. Don't leave minors by the side of the road or in unsupervised situations after an EMS encounter simply because they are not critically injured and parents cannot be contacted. Be sure to know your own state's laws and develop protocols to deal with these tricky situations.