Adolescents, the law, and informed consent
Things get complicated when the patient in a gynecologist's office is a minor seeking contraception.
Physicians have an ethical and moral responsibility to help patients make choices about their care and to obtain informed consent from them before providing treatment. Adults aged 18 and older generally can provide consent for themselves. The situation is more complicated, however, when the patient in a gynecologist’s office is a minor seeking contraception.
In every state, minors can provide their own consent for certain ob/gyn services, but those services vary by state and may or may not include contraception. As of July 1, 2015, in 21 states and the District of Columbia, all minors are explicitly allowed to consent to contraceptive services.1 In an additional 25 states, minors can provide their own consent for contraception under specific circumstances. Only 4 states have no explicit policy.
In Practical Pediatric and Adolescent Gynecology,2 Paula J. Adams Hillard, MD, and colleagues underscore the need for ob/gyns treating adolescents to understand the specifics of their state’s minor consent laws, including: 1. The scope of status exceptions 2. Scope of services covered 3. Age limits language 4. Language regarding the right of minors and; 4. Abortion consent or notification laws.
It’s also important to know that when family planning services are funded by the federal Title X Family Planning Program, minors must be allowed to consent to those services. Such services are available in approximately 75% of all US counties and the federal regulation on consent supersedes any state law that otherwise requires parental consent or notification.
REFERENCES
1. Guttmacher Institute. Minors’ access to contraceptive services. State Policies in Brief. https://www.guttmacher.org/statecenter/spibs/spib_MACS.pdf. Accessed July 30, 2015.
2. English A, Gudeman R. Legal Issues. In: Hillard PJA, ed. Practical Pediatric and Adolescent Gynecology. Oxford, UK: John Wiley and Sons, Ltd.; 2013;142–148.
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