Conclusion: Our Daughters' Decisions.
For some advocates of these more stringent approaches to parental involvement in the abortion decision, abortion may seem intrinsically different from other areas in which a minor may make her own decisions because it involves ending a fetus's potential for life, an act some people find morally unacceptable. If abortion is immoral, however, it is no less so if a parent or a judge sanctions the decision. For people who believe that abortion is morally wrong, the issue of parental involvement, logically, should be irrelevant.
Others might contend that abortion is different from other choices a minor may make for herself because it is an irrevocable decision. But so is the decision to have a baby. Few of those who might approve of parents' preventing their teenage daughter from having an abortion would argue that those same parents also have the right to force a teenager to have a baby. Moreover, once a teenager has a child, she is then permitted in most states to make another irrevocable decision: whether to raise the baby herself or place it for adoption. In the case of adoption, while she may have a brief period to change her mind, once the grace period ends, her parental rights are terminated.
Those who believe abortion is morally unacceptable might support laws mandating parental involvement as a way of preventing a minor from having an abortion altogether. Indeed, parental consent or notification requirements are often part of legislation designed to restrict overall access to abortion, and parental involvement statutes are usually introduced by opponents of legal abortion. However, the majority of Americans who support parental consent or notification laws probably do not share these special-interest political goals. Rather, they are more likely to want to ensure that a pregnant teenager receives adult guidance and support when considering all the options available to her, so that she can make a decision that is in her best interests. Yet, the evidence shows that mandatory parental involvement does not accomplish this objective and might actually be contrary to a minor's best interests. What steps can states take to promote a minor's best interests, with respect both to abortion and to other dec isions a teenager may face?
Ensuring Clarification and Consistency in State Laws
The clear trend in state law is to expand the right of a mature minor to make important decisions about his or her own health care and future and the future of his or her child. Statutes are an important means of clarifying and affirming the right of a minor to make important life decisions. As regards medical care, for example, state laws guarantee a minor confidentiality and remove a teenager's possible fear of being "found out" as an obstacle to seeking care and obtaining it without delay. For doctors and other health professionals who treat adolescents, statutes authorizing a minor to consent are a guarantee (except, of course, in cases of negligence) that these health providers can offer services to a teenager without fear of prosecution. (Even where state laws specifically authorize a minor to consent to health care, however, individual providers and health care agencies may refuse to treat a teenager without parental consent, probably largely out of concern about who is responsible for paying for the t reatment.)
Some states have been less diligent than others in clarifying and adopting a consistent approach to teenagers' decision-making authority (see Appendix Table 1). For example, in a number of states, a minor may consent to treatment for STDs, but not to other services related to sexual activity. Certain states authorize a minor to consent to prenatal care and childbirth services, but not to obtain confidential contraceptive services that could enable her to avoid an unplanned pregnancy. States that require parental involvement for abortion often allow a minor to place her child for adoption, without assigning any role in the decision to the grandparents. Some states permit a teenage mother to consent to her child's adoption, but not to medical care for the child. And other states leave a teenage mother in the anomalous position of being able to consent to medical care for her child, but not for herself.
The implementation of a clear and consistent approach to the whole area of legal rights for minors who might be faced with important medical or life decisions would result in two significant benefits: It would assure access to confidential health services for teenagers who feel that they cannot tell their parents about their health problems, thereby encouraging them to seek prompt medical treatment. It would also give health care providers and other professionals working with young people unambiguous guidelines as to the extent to which they can serve minors or act on their instructions, without involving the parents.
Creating Balanced Alternatives
In a dissent to the Supreme Court's 1990 decision upholding two-parent notification with a judicial bypass for abortion, Justice Thurgood Marshall noted that "if a state were concerned about ensuring that all minors consult with a knowledgeable and caring adult, it would provide for some form of counseling rather than for a judicial procedure in which a judge merely gives or withholds his consent." (60) A few states have enacted procedures other than a judicial bypass that seek to address the potential conflicts between the call for parental involvement and the teenager's right to confidentiality. Some of these identify professionals who, because of their training and experience in working with young people, may be better qualified than a judge, or even a physician, to counsel a pregnant adolescent about her options:
* West Virginia allows a doctor--who must be other than the physician who will perform the abortion and who may not have any professional or financial association with that physician--to waive the state's mandatory notification requirement (which includes a judicial bypass option) if he or she concludes that a minor is mature enough to make her own decision, or that notification would not be in her best interests.' (6) This approach is broadly consistent with a basic principle of medical ethics that a doctor must assess a patient's competence to give informed consent; however, the attending physician, rather than someone who is not involved in treating the patient, usually makes that determination.
* A 1991 Maryland notification law permits the attending physician to waive the parental notice requirement (which does not include a judicial bypass) if he or she believes that a minor is mature enough to make the abortion decision, that notice may lead to physical or emotional abuse of the minor or that it would otherwise not be in the minor's best interest; if the minor does not live with a parent; or if a "reasonable" effort to give notice has been unsuccessful. (62) The law is not being enforced, pending a statewide referendum to be held in November 1992.
* A 1990 Connecticut statute requires a teenager under 16 to be counseled by a doctor or other qualified professional (a psychiatrist, psychologist, social worker, family therapist, minister, physician's assistant, nurse or guidance counselor). The minor must be told of all her options for resolving an unplanned pregnancy, and must be informed that she can change her mind about having an abortion at any time before the procedure. The counselor must discuss with her the possibility of involving her parents or another adult family member, and must give the minor an opportunity to ask questions. After the counseling is completed, both the teenager and the counselor must sign a statement confirming that she has received the required information. (63)
* A 1989 Maine statute contains similar counseling provisions. (64) That law gives the teenager two options: the traditional approach of obtaining parental consent or judicial authorization for an abortion, or the option of receiving extensive counseling from a qualified professional.
By providing for thorough counseling for pregnant teenagers, Connecticut and Maine have recognized that the decision to have an abortion is a serious matter that--like the decision to give birth to a child and the decision to raise a child alone or place it for adoption--requires careful and thoughtful consideration.
While parents can often help a pregnant daughter resolve these difficult issues, ultimately the young woman herself must make each of these decisions, because it is her life that will be most affected by the choice she makes. The whole theory of informed consent is, after all, rooted in such respect for the rights and responsibilities of the individual.
(60.) Hodgson, v. Minnesota, 1990, op. cit. (see reference 26).
(61.) W. Va. Code, sect. 16-2F-3 (1991).
(62.) Md. Sen. Bill No. 162, enacted Feb. 18, 1991.
(63.) Connecticut Substitute H. B. 5447, enacted Apr.30, 1990.
(64.) Me. Rev. Stat. Ann. tit. 22, sect. 1597-A (1990).
RELATED ARTICLE: WHAT THE AGI STUDY SHOWS
* Nearly half the states (24) and the District of Columbia have laws authorizing a minor to consent to contraceptive services. No state has a law that requires a minor to obtain parental consent for these services.
* A majority of states (27) and the District of Columbia have statutes authorizing a teenager to consent to prenatal care and delivery services. No state has a law that requires a minor to obtain parental consent for these services.
* The District of Columbia and all but one state have laws affirming a minor's right to consent to the diagnosis of and treatment for STDs. No state has a law that requires a minor to obtain parental consent for these services.
* Most states (46) and the District of Columbia have laws that authorize a minor to consent to treatment for substance abuse.
* The District of Columbia and more than half of the states (28) authorize a minor to consent to treatment for emotional and psychological problems without parental involvement.
* More than one-third (21) of the states authorize a minor to consent to general medical and surgical care in nonemergency situations. In nearly half of these states, a minor who has reached a specified age (14-16) or who is mature enough to understand the nature and consequences of the proposed treatment may give consent.
* The District of Columbia and all but seven states allow a minor to drop out of school, despite the negative consequences associated with failure to earn a high school diploma.
* Most states (40) and the District of Columbia require parental consent before a minor can get married.
* In the District of Columbia and 28 states, a mother under the age of majority may consent to medical care for her child. No state mandates parental involvement in a minor's decision to authorize medical care for her child.
* In the District of Columbia and all but four states, a mother under the age of majority may consent to the adoption of her child without her parents' knowledge or consent.
* Only three states and the District of Columbia have statutes that permit a minor to obtain an abortion without her parents' knowledge or consent.
* More than one-third (18) of the states have laws that mandate parental consent or notification for a minor's abortion.
How the Study Was Conducted
The AGI compiled information on state statutes relating to an unmarried and unemancipated minor's authority to consent to contraceptive services, prenatal care and delivery services, services in connection with STDs and HIV infection, drug and alcohol abuse treatment, mental health care, general nonemergency medical care, abortion and, in the case of a minor parent, medical care for her child. We used three sources: J. Gittler, M. Quigley-Rick and M. J. Saks, Adolescent Health Care Decision Making: The Law and Public Policy, Carnegie Council on Adolescent Development, Washington, D. C., 1990; J. M. Morrissey, A. D. Hofmann and J. C. Thrope, Consent and Confidentiality in the Health Care of Children and Adolescents: A Legal Guide, Free Press, New York, 1986; and AGI's files of state laws and its State Reproductive Health Monitor: Legislative Proposals and Actions. Data on the age at which minors may marry without parental consent and drop out of school was collected from M. Guggenheim and A. Sussman, The Right s of Young People, Bantam, New York, 1985.
We then wrote a summary of the relevant laws and age limits for each state and sent this to the state's attorney general with a request for confirmation of the accuracy and currency of the information or for needed changes and the most recent statutory citation. In addition, we asked the attorneys general whether state law allowed a minor parent to consent to the adoption of her child and, if so, to provide the statute and the statutory citation.
The attorneys general of 30 states and the corporation counsel of the District of Columbia responded to our request for information. The accuracy and currency of our information for the remaining 20 states was checked through the bound volumes of state statutes and, in a few instances, through Westlaw, a computerized data base of state laws; Audrey Samers, an associate in the law firm of Fried, Frank, Harris, Shriver & Jacobson, conducted this check.
Information on the age of majority was compiled by Anne Martin of the AGI, through a telephone survey of state attorneys general conducted in August and September of 1991. For the few states that would not respond to our request for this information, the age of majority was obtained through research of state statutes.
To the best of our knowledge, the information in this report is accurate as of January 1, 1991. In some instances, we have included more recent information.
Appendix Table 1 Laws affecting an unmarried, unemancipated minor's right to make decisions about medical care, abortion and other important issues, 50 states and the District of Columbia STATE AGE OF MEDICAL CARE MAJORITY Contraceptive Prenatal care and services delivery services ALABAMA 19 NL MC ALASKA 18 MC MC ARIZONA 18 NL NL ARKANSAS 18 MC MC (14) CALIFORNIA 18 MC MC COLORADO 18 MC NL CONNECTICUT 18 NL NL DELAWARE 18 MC (4) MC (4,14) D.C. 18 MC MC FLORIDA 18 MC (28,29) MC (15) GEORGIA 18 MC MC HAWAII 18 MC (5,14,22,33) MC (5,14,22,33) IDAHO 18 MC NL ILLINOIS 18 MC (29) MC (15) INDIANA 18 NL NL IOWA 18 NL NL KANSAS 18 MC (44) MC (45) KENTUCKY 18 MC MC LOUISIANA 18 NL NL MAINE 18 MC (29) NL MARYLAND 18 MC (5,28) MC (5) MASSACHUSETTS 18 NL MC (14) MICHIGAN 18 NL MC MINNESOTA 18 NL MC (5) MISSISSIPPI 21 (58) MC (59) MC (15) MISSOURI 18 NL MC (5,14,15) MONTANA 18 MC (5) MC (5,15) NEBRASKA 19 NL NL NEVADA 18 NL NL NEW HAMPSHIRE 18 NL NL NEW JERSEY 18 NL MC (5,15) NEW MEXICO 18 MC NL (67) NEW YORK 18 MC MC (70) NORTH CAROLINA 18 MC (14,28) MC (14,28) NORTH DAKOTA 18 NL NL OHIO 18 NL NL OKLAHOMA 18 MC (73) MC OREGON 18 MC (5,75 NL PENNSYLVANIA 18 NL MC RHODE ISLAND 18 NL NL SOUTH CAROLINA 18 NL (77) NL (77) SOUTH DAKOTA 18 NL NL TENNESSEE 18 MC MC TEXAS 18 NL MC (14,15) UTAH 18 NL MC VERMONT 18 NL NL VIRGINIA 18 MC (28) MC (28) WASHINGTON 18 NL (84) NL (84) WEST VIRGINIA 18 NL (87) NL WISCONSIN 18 NL NL WYOMING 19 MC (91) NL STATE STD/VD HIV testing Treatment for drug services and treatment and alcohol abuse ALABAMA MC (4,5) NL MC ALASKA MC NL NL ARIZONA MC NL MC (4) ARKANSAS MC NL NL CALIFORNIA MC (4) MC (4,18) MC (4) COLORADO MC MC MC CONNECTICUT MC NL MC DELAWARE MC MC (4,18) MC (4,25) D.C. MC NL MC FLORIDA MC MC MC GEORGIA MC (5) NL MC (5) HAWAII MC (5,22,33) NL MC (5,34) IDAHO MC (22,35) NL MC ILLINOIS MC (4) NL MC (4,39) INDIANA MC NL MC IOWA MC MC MC KANSAS MC (5) NL MC (46) KENTUCKY MC NL MC LOUISIANA MC (5) NL MC (5,46) MAINE MC (5) MC (18) MC (5) MARYLAND MC (5) NL MC (5) MASSACHUSETTS MC NL MC (4,46,5) MICHIGAN MC (5,15) MC (5,15) MC (5,15) MINNESOTA MC (5) NL MC (5) MISSISSIPPI MC NL MC (2,21) MISSOURI MC (5,15) NL MC (5,61) MONTANA MC (5,15) NL MC (5,15) NEBRASKA MC NL MC NEVADA MC NL MC (46) NEW HAMPSHIRE MC (22) NL MC (4,46) NEW JERSEY MC (5,15) NL MC (5,66) NEW MEXICO MC MC (18) MC (46) NEW YORK MC MC (18) MC (25) NORTH CAROLINA MC NL MC NORTH DAKOTA MC (22) NL MC (22) OHIO MC MC (18) MC OKLAHOMA MC NL MC OREGON MC NL MC (22,46) PENNSYLVANIA MC NL MC RHODE ISLAND MC MC (18) MC SOUTH CAROLINA NL (77) NL (77) MC SOUTH DAKOTA MC NL MC TENNESSEE MC NL MC (5,46) TEXAS MC (15) NL MC UTAH MC NL NL VERMONT MC (4,80) NL MC (4,80) VIRGINIA MC NL MC (81) WASHINGTON MC (22) NL MC (22,81) WEST VIRGINIA MC NL MC WISCONSIN MC NL MC (4) WYOMING MC NL NL STATE Mental health services Outpatient Inpatient ALABAMA MC (6,7) MC (6,7) ALASKA NL NL ARIZONA NL NL ARKANSAS NL NL CALIFORNIA MC (4,19) NL COLORADO MC (5,21) MC (5,21) CONNECTICUT NL MC (22) DELAWARE NL NL D.C. MC (6) MC (6) FLORIDA MC (4,30) MC (30,31) GEORGIA NL MC (4,32) HAWAII NL NL IDAHO NL PN (36) ILLINOIS MC (4,5,40) PN (36) INDIANA NL NL IOWA NL NL KANSAS NL PN (36) KENTUCKY MC (8) MC (8) LOUISIANA NL MC (8) MAINE MC (5,6) MC (5,6) MARYLAND MC (5,6,8) MC (5,6,8) MASSACHUSETTS MC (8) MC (8) MICHIGAN MC (22,55) NL MINNESOTA NL MC (8) MISSISSIPPI NL NL MISSOURI NL NL MONTANA MC (8) MC (8) NEBRASKA NL NL NEVADA NL MC NEW HAMPSHIRE NL NL NEW JERSEY NL NL NEW MEXICO MC (68) PC NEW YORK MC MC (8) NORTH CAROLINA MC NL NORTH DAKOTA NL NL OHIO MC (22,72) NL OKLAHOMA NL NL OREGON MC (22) NL PENNSYLVANIA NL PN (36) RHODE ISLAND NL NL SOUTH CAROLINA NL (77) MC (8) SOUTH DAKOTA NL NL TENNESSEE MC (8) PN (36) TEXAS MC MC (8) UTAH NL MC (8) VERMONT NL MC (22) VIRGINIA MC NL WASHINGTON MC (85) PN (36) WEST VIRGINIA NL NL WISCONSIN NL NL WYOMING NL NL STATE ABORTION DECISION ON SERVICES (1) MINOR'S OWN BEHALF General nonemergency Dropping out medical care (2) of school ALABAMA MC (7) PC MD (8) ALASKA MC (10) NL MD (8) ARIZONA NL NL (12) MD (8,13) ARKANSAS MC (15, 16) PN (17) MD (8) CALIFORNIA NL NL (12) NA (20) COLORADO NL NL MD (8) CONNECTICUT NL MC (23) MD (8,13) DELAWARE NL NL (26) MD (8) D.C. NL MC MD (8,13) FLORIDA NL NL (12) MD (8) GEORGIA NL PN MD (8) HAWAII NL NL (26) NA (20) IDAHO MC (37) PN (17,38) MD (8) ILLINOIS MC (15,41) NL (42) MD (8) INDIANA NL PC MD (31) IOWA NL NL MD (8,13) KANSAS MC (8,15,47) NL MD (8) KENTUCKY MC (10) NL (12) NA (20) LOUISIANA MC (5,15,49) PC MD (31) MAINE NL MC (51) MD (31) MARYLAND MC (5,10) NL (52) MD (8) MASSACHUSETTS MC (10,14,15,28,41) PC (54) MD (8) MICHIGAN NL PC MD (8) MINNESOTA MC (10) PN (17) MD (8,57) MISSISSIPPI MC (15,18) NL (12) MD (31) MISSOURI MC (10) PC MD (8) MONTANA MC (5,10,15) NL MD (8,63) NEBRASKA NL PN MD (8) NEVADA MC (10,16,28) NL (42) MD (31) NEW HAMPSHIRE MC (16) NL MD (8) NEW JERSEY NL NL MD (8) NEW MEXICO NL NL MD (8,69) NEW YORK MC (10) NL MD (7,71) NORTH CAROLINA NL NL (26) MD (31) NORTH DAKOTA NL PC (54) MD (8) OHIO NL PN NA (20) OKLAHOMA MC (10) NL NA (20) OREGON MC (5,15,21) NL MD (76) PENNSYLVANIA MC (73) NL (12) MD (31) RHODE ISLAND NL PC MD (8) SOUTH CAROLINA MC (8,77) PC (78) MD (8) SOUTH DAKOTA NL NL MD (8) TENNESSEE NL NL (12) MD (8) TEXAS NL NL (26) MD (31) UTAH NL PN (17,38) NA (20) VERMONT NL NL MD (8) VIRGINIA NL NL (82) NA (20) WASHINGTON NL NL (84) MD (86) WEST VIRGINIA NL PN (88) MD (8) WISCONSIN NL MC (90) MD (8) WYOMING NL PC MD (8) STATE DECISION DECISIONS ON BEHALF ON MINOR'S OF MINOR'S CHILD OWN BEHALF Getting Medical care Placing child married for child for adoption (3) ALABAMA PC MC MC (9) ALASKA PC MC MC (11) ARIZONA PC NL MC ARKANSAS PC MC MC (11) CALIFORNIA PC NL MC COLORADO PC MC MC CONNECTICUT PC MC MC (24) DELAWARE MD (27) MC MC D.C. PC MC MC FLORIDA MD (27) MC MC (11) GEORGIA MD (27) MC MC HAWAII PC NL MC IDAHO PC MC MC ILLINOIS PC MC MC INDIANA PC NL MC (43) IOWA PC NL MC (11) KANSAS PC MC MC KENTUCKY MD (48) MC MC (24) LOUISIANA MD (50) MC MC (11) MAINE PC NL MC (11) MARYLAND MD (27) MC MC (11) MASSACHUSETTS PC MC MC (11) MICHIGAN PC MC PC (56) MINNESOTA PC MC PC MISSISSIPPI MD (60) MC MC MISSOURI PC MC (62) MC MONTANA PC MC (5) MC (64) NEBRASKA MD (31) NL MC (11) NEVADA PC MC MC NEW HAMPSHIRE PC NL MC (65) NEW JERSEY PC MC MC NEW MEXICO PC NL MC NEW YORK PC MC MC NORTH CAROLINA PC NL MC NORTH DAKOTA PC NL MC OHIO PC NL MC OKLAHOMA MD (74) MC MC (8) OREGON PC NL MC (11) PENNSYLVANIA PC MC PN RHODE ISLAND PC MC PC SOUTH CAROLINA PC MC MC SOUTH DAKOTA PC NL MC (11) TENNESSEE PC NL MC TEXAS MD (79) NL MC (11) UTAH PC MC MC VERMONT PC NL MC VIRGINIA PC NL (83) MC WASHINGTON PC NL MC (24) WEST VIRGINIA PC NL MC (89) WISCONSIN PC NL MC (11) WYOMING PC NL MC
NL = No law found
MC = Minor may consent
PC = Parental consent required
MD = Minor may decide
PN = Parental notice required
NA = Not applicable
(1)Includes only parental consent and notification laws that are currently being enforced. These laws include a judicial bypass except where indicated.
(2)States with no law relating specifically to unmarried and unemancipated minors may have a law authorizing married and emancipated minors or teenagers over the age of majority to consent to general medical care that, by implication, requires unmarried and unemancipated minors to have parental consent.
(3)In addition to the consent of the minor mother, some states require consent of the unwed father if he can he located or if paternity has been established, but others do not require the Lather to be informed of adoption proceedings.
(4)Minor must be 12 or older; in Arizona, applies to a minor seeking treatment for drug abuse but not for alcohol abuse.
(5)Physician may notify parents; in Maryland, the law prohibits disclosure of information about an abortion; in Georgia, notification prevision applies to treatment for drug abuse only.
(6)Law does not distinguish between outpatient and inpatient services; it was therefore assumed that a minor may consent to both.
(7)Minor must be 14 or older, a high school graduate, married, pregnant or a parent.
(8)Minor must be 16 or older; in Vermont, minor under 16 may drop out of school after completing 10th grade.
(9)Minor must be represented by an attorney.
(10)Minor may consent if she has a child.
(11)Law makes no distinction between minor and adult parents, and it was therefore assumed that the consent of a minor parent is sufficient.
(12)Enforcement of a law requiring parental consent or judicial bypass is enjoined.
(13)Minor may drop out at age 14 if employed and, in the District of Columbia, after completing eighth grade.
(14)Law excludes abortion.
(15)Law includes surgery; in Massachusetts, law excludes psychosurgery.
(16)Minor may consent if mature enough to understand the nature and consequences of the proposed treatment.
(17)Both parents must be notified unless one parent is not readily available; in Minnesota, a "diligent" effort must be made to locate both parents (see: Minn. Stat., sect. 144,343(2)-(6)); in Arkansas, a "reasonably diligent effort" must be made (see Ark. Code Ann., sect. 20-16-801 et seq.).
(18)Law applies to testing only.
(19)Law applies to a minor who is mature enough to participate "intelligently" in treatment or counseling and would present a danger to himself or herself or others, or is an alleged victim of incest or child abuse; parents shall be involved unless health professional thinks involvement would be inappropriate.
(20)State law does not allow a minor to drop out of school before graduation.
(21)Minor must be 15 or older.
(22)Minor must be 14 or elder.
(23)Minor under 16 must receive intensive counseling from physician or other qualified professional, who must discuss the possibility of involving the minor's parents.
(24)Miner parent must have court-appointed guardian (guardian ad litem).
(25)Law applies to treatment for alcohol abuse only.
(26)Law authorizing a minor to consent to prenatal care and delivery services excludes abortion; however, this condition imposes a blanket prohibition on abortion without parental consent and therefore appears to be unconstitutional under Supreme Court decisions.
(27)Minor who is pregnant or has a child may marry without parental consent; in Florida, a judge must authorize a marriage in such circumstances; in Maryland, the minor must be at least 16.
(28)Law excludes sterilization.
(29)Minor may consent if she is pregnant era parent, or if a doctor believes she may suffer a health hazard if services are not provided. Illinois law also authorizes miner to consent if referred by a physician or Planned Parenthood clinic; Maine law does not apply to pregnant minors.
(30)Law requires hearing to determine voluntariness.
(31)Minor must be 17 or older.
(32)Minor may consent to observation and diagnosis only; parental consent needed for treatment.
(33)Law excludes surgical procedures.
(34)Minor may consent to counseling services only.
(35)Minor may consent to diagnosis and treatment of contagious, infectious and reportable diseases.
(36)Minor may consent, but parent must be notified upon minor's admission. In Illinois and Tennessee, minor must be 16 years old to consent to admission; in Idaho, Kansas and Pennsylvania, 14 years; in Washington, 13 years.
(37)The state's medical consent statute permits "any person of ordinary intelligence and awareness" to consent to hospital, medical, surgical or dental care (see: Idaho Code, sect. 39-4302). However, a later section of the law appears to give parents the authority to consent for a minor child (sect. 39-4303). According to the attorney general's office, the agency "frequently" interprets the law as anthorizing minors to consent (R. Hardin, deputy attorney general, personal communication to P. Donovan, AGI, Oct. 22, 1990.)
(38)Law does not include judicial bypass.
(39)"Reasonable" efforts must be made to involve minor's family in treatment for drug abuse; physician must notify parents within three months of initiation of treatment for alcohol abuse (see: Ill. Rev. Stat., ch. 111, pars. 4504, 4505).
(40)Minor may consent to five outpatient sessions.
(41)Minor may consent if she is pregnant.
(42)Enforcement of a law requiring parental notice or judicial bypass is enjoined.
(43)Minor may consent unless court determines that it is in the best interests of the child being adopted to require the consent of a minor parent's parent.
(44)State law permits family planning services to be provided to "any person who is over 18 years of age and who is married or who has been referred ... by a person licensed to practice medicine and surgery." (See: Kan. Stat. Ann., sect. 23-501 .) According to the Kansas attorney general, a city or county would not be subject "to any liability for providing contraceptive services to minors [without parental consent] that does not exist with respect to providing such services to adults." (See: letter from Attorney General Robert T. Stephan to Thomas R. Powell, city attorney, and Henry H. Blase, county counselor, Wichita, Kans., Dec. 6,1989; and Attorney General Opinion No. 87-66.)
(45)Minor may consent when parent is not "available." The statute does not define available. (See: Kan. Stat. Ann., sect. 38-123 .)
(46)Law applies to treatment for drug abuse only.
(47)Minor may consent if parent is not "immediately available." (See: Ran. Stat. Ann., sect. 38-123b .)
(48)A pregnant minor may marry without parental consent, but with court approval.
(49)Minor who believes he or she is afflicted by an "illness or disease" may consent to treatment. (See: La. Rev. Stat. Ann., sect. 40:1095 .)
(50)Judge may authorize marriage of minor of any age without parental consent "when there is a compelling reason." (See: La. Rev. Stat. Ann., sect. 9:212 (Supp. 1991).)
(51)Minor must have the consent of parent or other adult family member, or use the judicial bypass, or be counseled by the attending physician or a counselor, who can be a psychiatrist, psychologist, social worker, ordained clergyman, physician's assistant, nurse practitioner, guidance counselor or nurse.
(52)Law requires notification of one parent with no bypass. However, a physician may waive notification if the minor does not live with a parent; if the doctor determines that the minor is mature enough to give informed consent or that notification may lead to physical or emotional abuse of the minor, or otherwise be contrary to her best interests; or if reasonable effort to give notice was unsuccessful. The statute is not being enforced, pending a statewide referendum on the law in November 1992.
(53)Minor may consent if found drug-dependent by two doctors; bars consent to methadone maintenance therapy and treatment with antipsychotic medication.
(54)Both parents must consent. If parents are divorced, only the custodial parent must consent; in Massachusetts, the same is true if one parent is "unavailable." (See: Mass. Gen. Laws c. 112,s. 12F.)
(55)Law excludes abortion referral services and chemotherapy; minor may consent to 12 sessions or to services over a period of four months.
(56)Minor must have the consent of parent, guardian or court-appointed guardian.
(57)Age will change to 18 in the year 2000.
(58)General age of consent to medical care is 18; however, any minor who is mature enough to understand the nature and consequences of the proposed medical or surgical treatment may consent.
(59)Minor may consent if referred by a doctor, clergyman, family planning agency, school or state agency.
(60)Females 15 or older and males 17 or older may marry without parental consent; however, parents must be notified if either party is under age 21.
(61)Law includes surgical care and hospital admission.
(62)Minor parent may also consent to medical care for any child in his or her legal custody.
(63)Minor must have completed eighth grade.
(64)Another statute bars a minor from entering into contracts, so attorney general's office reported that parental Consent is usually required. (S. Nelson, Montana Juvenile Justice Bureau, personal communication to P. Donovan, AGI, Dec. 2,1990.)
(65)Court may require consent of minor parent's parent.
(66)Parents must be notified if minor is admitted to a facility for alcohol abuse.
(67)Minor may consent to testing and examination to confirm pregnancy.
(68)Any minor may consent to counseling or psychotherapy; a minor 14 or older may consent to psychotropic (mind-affecting) medication or behavior modification program unless the parent objects.
(69)Minor may drop out if authorized by local school board.
(70)Law refers to prenatal care; includes medical and hospital services.
(71)Minor must be 17 in New York City.
(72)Law excludes use of medications; covers period of 30 days or six sessions, after which parent must consent to further treatment.
(73)Minor may consent if she has ever been pregnant.
(74)Minor may marry without parental consent if she has given birth to an illegitimate child or is pregnant and the marriage has been authorized by a court.
(75)A minor 15 or older may consent to sterilization if "all less drastic alternative contraceptive methods...have proved unworkable or inapplicable or are medically counter-indicated." (See: Or. Rev. Stat., sect. 436.205(c) .)
(76)Minor may drop out at age 16 if employed.
(77)Minor 16 or older may consent to any legal health services except operations.
(78)Consent may be given by grandparent.
(79)Minor 16-18 may petition court for permission to marry, but must be represented by a court-appointed guardian to speak for or against the petition, and the parents must be notified. The court may authorize the marriage if it determines it to be in the minor's best interest.
(80)Parents must be notified if minor needs immediate hospitalization.
(81)Minor may consent to outpatient services only.
(82)Attorney general says statutory history of law authorizing a minor to consent to services in connection with birth control, pregnancy and family planning indicates that the law is intended to encompass abortion. (C. S. Nance, assistant attorney general, personal communication to J.I. Rosoff, AGI, Aug. 28,1990.)
(83)According to attorney general, since nothing in the Code of Virginia defines the ago at which a person is capable of giving consent, "it would appear that a minor parent may provide consent to medical care for his or her child." (Ibid.)
(84)Mature minor is authorized to consent under State v. Koome, 84 Wn. 2d 901,530 P. 2d 260 (1975).
(85)Minor must be 13 or older.
(86)Minor may drop out at age 15 if employed or if school superintendent determines that minor is proficient in grades 1-9.
(87)State law bars minor from consenting to sterilization.
(88)Notification (or use of judicial bypass) can be waived if second physician determines that minor is mature enough to give consent or that notice would not be in her best interests.
(89)Minor may consent unless court concludes minor's age precludes informed consent.
(90)Abortion provider must "strongly encourage" minor "to consult" her parents or another family member or appropriate person. Every provider must have a policy on parental involvement that includes information on the availability of services to assist the minor in involving her parents. (See: Wis. Stat. Ann., sect. 146.78(5).)
(91)State-supported family planning services may be provided to "any person who may benefit from these services." (See: Wyo. Stat., sect. 42-5-101(a).)