Adolescent Health: Consent and Confidentiality

Medical care requires the consent of the patient or a legally authorized representative. In the case of minors, the consent of one or both parents usually is required to authorize medical care. However, there are numerous exceptions to this rule: in every state, minor adolescents are authorized to give their own consent for health care under certain circumstances—based on the adolescents’ status or on the services that they are seeking or both. These state statutes—commonly known as “minor consent statutes”—vary widely among states.

Status. The categories of minors who may consent to their medical care include, among others, emancipated minors, married minors, minors in the armed forces, mature minors, minors living apart from their parents, minors over a certain age, high school graduates, pregnant minors, and minor parents.

Services. As with the status exceptions, statutes that authorize minors to consent to their own health care based on the type of service vary widely among states. Most common, the services in question are so-called sensitive services: pregnancy-related care, contraception, services for sexually transmitted infections, mental health care, or drug and alcohol services, or all of such services. Emergency care also is frequently included.

In many cases, service and status provisions coexist in the same law: California, for example, authorizes minors 12 and over to consent to treatment of sexually transmitted diseases (or other infectious, contagious, or communicable diseases) (Cal. Fam. Code § 6926). Other provisions of minor consent laws also vary significantly from state to state. Some statutes specifically include confidentiality provisions, and others specify that parents are not financially liable for care to which they do not give consent.

While a number of states specifically permit minors to consent to abortion services, a majority of states do the opposite: more than half the states enforce laws requiring parental consent or parental notification before a pregnant minor may receive this service. Details on state laws related to abortion are available from the Center on Reproductive Law and Policy or from the National Abortion and Reproductive Rights Action League.

You need to be familiar with your state’s minor consent laws for better representation of children who live with their families. Also, these laws are essential gateways to health care for minors in foster care, in the juvenile justice system, and living on their own. For details on each state’s laws, contact your state medical associations or the Center for Adolescent Health and the Law. For a comprehensive listing of state minor consent statutes, see Abigail English et al., State Minor Consent Statutes: A Summary (Center for Continuing Education in Adolescent Health, Children’s Hospital Medical Center, Cincinnati, 1995); an updated version will be published by the Center for Adolescent Health and the Law in 2002.

Catherine Teare

Catherine Teare is director of policy,

Children Now,

1212 Broadway, 5th Floor,

Oakland, CA 94612;

510.763.2444.

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