Can removing a child from medical care against doctor's advice be grounds for terminating parental rights?

This question has been addressed in 1 Texas court opinion:

In The Interest of O.T.D.H.C. and M.E.C. A/K/A M.C., III, Children

COA14 — January 27, 2026

The Fourteenth Court of Appeals affirmed a trial court's order terminating a mother’s parental rights following an investigation that began when she removed her injured child from a hospital against medical advice. The investigation revealed a history of domestic violence, substance abuse (testing positive for cocaine and methamphetamines), and untreated mental health conditions. On appeal, the mother conceded to the predicate finding of endangering conduct, leading the court to focus on the children's best interest. The court held that while the mother had secured housing and employment, her failure to successfully complete drug treatment or address her bipolar disorder and PTSD provided legally and factually sufficient evidence to support termination under the Holley factors.

Litigation Takeaway

“In termination cases, "checking the boxes" by securing a job and a home is often insufficient if a parent fails to complete the "psychological" components of their service plan. Courts prioritize a parent's behavioral stability and the resolution of substance abuse or mental health issues over material gains when determining the best interest of the child.”