As a parent, your child’s health is in your hands – until it isn’t. Before they reach their teens, in some cases, confidentiality laws allow kids to obtain certain types of health care without your knowledge. And privacy protections may be strongest exactly around topics parents might feel the most need to know: mental health issues, substance abuse problems, pregnancy prevention and sexually transmitted diseases.
Birth Control – Beyond Parental Control
While looking through your 14-year-old daughter’s purse for the sunglasses she borrowed, you instead find a birth control pack with her name printed on the label, along with that of the prescribing doctor – her pediatrician. Among the thoughts racing through your brain is “Why wasn’t I told?”
It’s likely that unless she gave explicit consent for the doctor to tell you, your daughter’s confidentiality is protected by law, depending on her age and where your family lives.
“In the state of Washington, if children are over 14, they have the right to reproductive care without parental knowledge or consent,” says Cora Breuner, a professor of pediatrics and adolescent medicine at Seattle Children's Hospital and the University of Washington School of Medicine. “Even though [parents] might get upset, our mission is to support the requests of the 14-year-old. And so it might cause an argument in the house, but it is something that we are supported legally for doing,” says Breuner, also a member of the Committee on Adolescence for the American Academy of Pediatrics.
It’s the Law
In every state, at least some law exists that allows minors to seek certain types of treatment and give their own consent, says Abigail English, legal counsel at the Center for Adolescent Health & the Law in Chapel Hill, North Carolina.
The primary purpose is to avoid underuse of medical services – so kids won’t shy away from getting care they need, especially when it comes to sexual health, substance abuse and mental health treatment.
In some states, adolescents can also consent to their own general medical care – in Alabama, for instance, that’s at age 14 or older.
Issues in reproductive health care – anything related to sexual health – “have been looked at in research really carefully to figure out the difference if you protect teens’ confidentiality,” says Claudia Borzutzky, an assistant professor of clinical pediatrics at the University of Southern California's Keck School of Medicine. Studies suggest that teens are more likely to seek out health care when privacy is assured.
In many states, kids 12 and older don’t need parental consent for STD diagnosis or care, while other states allow consent by minors without specifying age, including treatment or testing for HIV/AIDS.
With contraception, teens may want “to be responsible and take charge and get on some reliable form of contraception, so they don’t have an unplanned pregnancy,” but might skip that step for fear of their parents being told, says Borzutzky, also a specialist in adolescent medicine at Children’s Hospital Los Angeles.
Emergency contraception is a bit different, she says, because it’s available to girls over the counter. However, she will provide prescriptions on request to make it more affordable, depending on the patient’s insurance coverage.
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