Joint Legal Custody and Medical Decisions: Who Makes the Decisions?

Parents with joint legal custody collaborate on medical decisions for their children. They talk to one another before setting vaccine appointments, approving some types of surgeries, or choosing a child’s therapist. 

Clear communication is critical for successful joint custody partnerships. If you don’t agree with your partner on an important medical decision, a mediator can help you find common ground. 

Understanding child custody and medical decisions 

Two forms of custody exist in the United States: physical and legal. A parent who has physical custody resides with the child. A parent who has legal custody makes decisions for the child. Parents who share physical custody often share legal custody, too. 

Close to 35% of divorced people share custody. Typically, these plans are determined by courts during the divorce process. 

Most states (such as Alaksa) assess a child's best interests when crafting a custody plan. They examine a child's needs, your ability to meet them, and your relationship with the child. 

If you've ever neglected or abused your child, you might lose legal or physical custody of your child during the divorce. You still have rights, and you're expected to maintain a relationship with the child through regular visits, but your decision-making abilities are limited. 

Read every document you're presented during your divorce to understand your rights. If your ex has sole legal custody of your child, you can't make most medical decisions. 

Who decides if a child gets vaccinations?

Many medical appointments for young children involve vaccines. The national vaccination rate among young children is declining, and for some parents, these shots are contentious topics. You may want a child to get a vaccine, and your ex may disagree. 

If you have joint legal custody, you must collaborate and decide together whether or not your child gets vaccinations. Your parenting plan may include an explicit mention of vaccines, but if it does not, you must come together and decide. 

If you have sole legal custody, you can vaccinate your child (or not) regardless of your ex's opinion. The decision is yours and yours alone. 

Worksheet: Create a Co-Parenting Plan

Which parent has legal authority in a medical emergency?

Parents sharing legal custody are both equipped to make decisions when a child is sick or hurt. If you don’t have time to tell your ex about a child’s health and need to make a decision, you can do so. But you must notify the other parent as soon as possible and keep them apprised of your child’s progress. 

Even parents without joint or sole legal custody can make emergency medical decisions in states like California. But communication is critical. You can’t keep a parent with sole or shared joint custody out of medical decisions indefinitely. You must tell them what’s happening as soon as possible. 


What if you disagree after divorce?

Custody decisions made during a divorce are difficult to change. In most states (including Connecticut), you must prove that something is substantially different since your divorce. A simple disagreement is rarely enough to convince a court to give one parent sole custody and cut the other out. 

Ask your child's doctor, nurse, or medical professional to explain why one treatment (or lack of treatment) is better than another. Medical professionals may be uncomfortable mediating between arguing parents, but they can help you both to understand why one option is preferable from a health perspective.

Professional mediators can also help you find common ground. Experts say people like this can settle more than 75% of disputes before they go to trial, saving people money and time. A meeting with a mediator could help you settle one question, such as a medical decision about your child, and this process could set the stage for better future collaboration. 


Watch: Do I have to share custody 50/50 with my ex after divorce?


Increases in Shared Custody after Divorce in the United States. (June 2022). Demographic Research. 
Parenting and Custody. (April 2019). Alaska Court System. 
How Distrust of Childhood Vaccines Could Lead to More Breakouts of Preventable Diseases. (August 2022). Association of American Medical Colleges. 
Basics of Custody and Visitation Orders. Judicial Branch of California. 
Motion for Modification. (March 2020). State of Connecticut Superior Court. 
Appellate Mediation: Why Is It So Hard to Settle During an Appeal? (September 2019). American Bar Association.