Pregnancy, teenagers and the law, 1974.

This analysis of laws is based in large part on statutes, court decisions and attorneys general opinions which have been reported in Family Planning/Population Reporter, a bimonthly publication of the Center for Family Planning Program Development. These reports regularly update the analysis of Family Planning, Contraception, and Voluntary Sterilization: An Analysis of Laws and Policies in the United States, Each State and Jurisdiction (as of September 1971), prepared by the Center for Family Planning Program Development for DHEW (see reference 9). Earlier articles by Harriet F. Pilpel and Nancy F. Wechsler on legal problems encountered by teenagers in obtaining contraceptive services appeared in the Spring 1969 and the July 1971 numbers of Family Planning Perspectives.

Summary

The past five years have seen a marked expansion of the legal rights of teenagers. Most significant has been the reduction of the age of majority from 21 to 18 in 40 states, reflecting recognition of the increased maturity of today's teenagers. (*) In the majority of cases, this development followed the adoption of the 26th Amendment to the U.S. Constitution which permits 18-year-olds to vote.

In the area of medical care, several states have in the past few years, by statute or judicial decision, endorsed the "mature minor doctrine," under which a minor who is sufficiently mature to understand the nature and consequences of a medical treatment proposed for his benefit may effectively consent to it. Other states have enacted specific legislation affirming the right of individuals younger than 18 to consent to medical care in general or to contraceptive services, pregnancy-related care and treatment for venereal disease in particular. The courts have also broadened their recognition of the constitutional rights of minors, invalidating parental consent requirements for abortion and raising serious questions about the validity of such requirements for contraception and other forms of medical care.

As a result of these developments -- and in particular of the generally reduced age of majority -- in 1974, the right of an 18-year-old unmarried woman to consent for all aspects of her own medical care including contraception has been affirmatively established in 45 states and the District of Columbia. (+) In 48 states and the District she may consent for most pregnancy-related health services, and for abortion; (++) and she may be treated on her own consent for venereal disease in all states without exception (ss) (see Table 1).

Although the rights of young people below the age of 18 have been expanded as well, some members of this group still encounter considerable difficulty in obtaining medical contraceptive services, and even greater difficulty in terminating an unwanted pregnancy without parental consent. As can be seen from Table 1, 23 states and the District of Columbia have affirmed the right of young people under the age of 18 to obtain contraceptive care, 16 states and the District have affirmed the right of these younger teenagers to consent to abortion, and 11 states have affirmatively established their right to consent to medical care in general (No doubt, many other states may be expected to follow suit in one or more of these respects when called upon to decide the issue.)

The problem faced by minors seeking medical services stems mainly from physician anxiety concerning the old common law (or judge-made) 'rule' that the consent of a parent or guardian is required before a doctor may provide any kind of medical treatment for a minor. However, there have always been exceptions to that rule, such as treatment in case of medical emergency and treatment of minors who are legally emancipated. (**) In addition, virtually all of the states have statutes which provide for medical treatment of neglected or abused minors, usually holding that the courts may order medical care for such children even over parental objection.

Recent Developments

In recent years, as noted above, a new exception has been made for the minor who is sufficiently intelligent and mature to understand the nature and consequences of a treatment which is for his or her benefit. This exception, commonly entitled the "mature minor doctrine," may be viewed as a logical corollary of the requirement of informed consent for medical care -- namely, the minor can give a valid and informed consent only if he or she understands the nature and purpose of the proposed treatment, its probable outcome, and voluntarily requests it. Acceptance of the doctrine, although not universal, is growing; it has been recognized by statute in four states, (*) and by judicial decision in a number of others. The mature minor doctrine has been invoked by a New York federal court with respect to an 18-year-old girl who had an abortion, (1) by the Washington Supreme Court with respect to an 18-year-old married minor who consented to a vasectomy, (2) by the Ohio Supreme Court with respect to an 18-year-old gi rl who consented to plastic surgery on her nose, (3) as well as by courts in Kansas (4) and Michigan. (5) The majority of judges in the Ohio case rejected the view that the validity of consent to medical care depends on the consenting party's capacity to contract. Instead, the judges used analogies from the fields of criminal and tort law, such as the age at which a person can be held responsible for criminal conduct and can "assume the risk" in a negligence case and the age at which a girl's consent to sexual intercourse precludes it from being considered rape. It is probable that courts in other states, when and if the question is before them, will similarly find that the mature minor rule applies.

Under all these exceptions, a physician may treat a minor even though parental consent has not been obtained. In the few suits which have been brought contending that contraceptive services may not be rendered to minors without parental consent, the courts have tended to rely on one or more of these exceptions. We know of no case in which a doctor was held liable for damages for providing contraception to a minor of any age without parental consent, or indeed for supplying any medical service, where the minor was older than 15, the treatment was for the minor's benefit, and it was provided with the minor's consent. Nevertheless, doctors, hospitals and health agencies are often reluctant to prescribe contraceptives for, or even to examine, minors without parental consent because of fear of damage suits for technical assault or malpractice, even though we know of no such suit that has ever succeeded. (+)

Teenagers and Contraception

When access to medical contraceptive services is denied to unwed, sexually active teenagers, unintended pregnancy is likely to result, with often disastrous medical, social and economic consequences. Three in 10 unwed teenagers who have had sexual intercourse experience at least one out-of-wedlock pregnancy, and three-quarters of all pregnancies to teenagers occur outside of marriage. (6) Births to teenagers--especially if they occur out-of-wedlock and the teenager is under 18--expose the mother and infant to greatly increased risk of mortality or irreversible injury; and even if both survive physically unharmed, their life chances are likely to be considerably thwarted as a result of the timing and circumstances of the birth. (7)

Mindful of the fact that adolescents frequently hesitate to seek needed contraceptive services if parental consent is required, numerous national physician and health organizations have endorsed the physician's right to exercise his medical judgment, free of legal barriers, in the provision of contraceptive care for the best interests of his minor patients. These groups include the American Medical Association, the American College of Obstetricians and Cynecologists, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College Health Association, the Association of Planned Parenthood Physicians and the American Public Health Association. Most recently, the National Association of Children's Hospitals and Related Institutions endorsed a medical "Bill of Rights" which would give young people confidential access to a variety of medical services, including contraception and abortion, without requiring parental consent. (8)

DHEW's national survey of family planning laws, and policies documented "a strong trend" for states to enact legislation "giving minors access to effective birth control services on their own consent and initiative." (9) This liberalizing trend has been marked by the enactment of statutes in recent years in 13 states and the District of Columbia specifically permitting broad categories of minors to consent to contraceptive services. (*) Twelve other states have laws authorizing publicly sponsored family planning programs which appear to permit services at least to some minors without parental consent. (+)

More than half of the states have enacted laws enabling legally emancipated minors to consent to all kinds of medical care. These states have put into statutory form the common law exception for such minors. Still other states have passed laws reducing below 18 the age at which minors may consent for medical care in general. That age is now 14 in Alabama, 15 in Oregon, and 16 in South Carolina; and statutes in Arkansas, Idaho, Mississippi and New Hampshire recognize the right of 'mature' minors, regardless of age, to consent for medical care. A 1974 Montana statute enables a physician to "render nonemergency services to minors for conditions which will endanger the health or life of the minor if services would be delayed by obtaining consent from spouse, parent . . . or legal guardian." (10)

Not all recent developments have expanded teenagers' access to contraceptive services. In a three to two decision handed down in May, 1973, the Utah Supreme Court overturned a trial court's ruling that the requirement of parental consent for contraceptive services to girls older than 14 and boys over 16 was a violation of the minors' constitutional right of privacy. The Utah Supreme Court said that "the giving of information or contraceptive paraphernalia to a minor child so as to avoid pregnancy from unlawful sexual relations would certainly tend to make a child of immature judgment more likely to commit the crime of fornication and to become infected with venereal disease, to say nothing of the morals of the situation." (11) The U.S. Supreme Court declined to review the case. (12)

In Rochester, Minnesota, six couples brought a class action on behalf of all the Rochester parents of unemancipated minors to enjoin the local Planned Parenthood organization from providing contraceptive services to minors without parental consent. At a preliminary stage of the proceeding, a Minnesota district court judge ruled in January, 1973, that Planned Parenthood could continue to provide contraceptive information and supplies to minors except those whose parents specifically notify Planned Parenthood that they do not wish their child to receive such services. (13) The plaintiffs are currently seeking a full trial in the Minnesota case. A similar action has been brought by a group of parents in Indiana.

Despite these few cases, however, the trend has been consistently in the direction of liberalization of laws affirming the right of young people to consent for their own contraceptive care. While changes in the age of majority play a large part in the establishment of this trend, it must be noted that teenagers who are minors may in 1974 consent for contraception in at least 22 states and the District of Columbia (see Table 1, p. 143). Just five years before, there was virtually no state in which this right was clearly affirmed by statute. (14) This trend appears to reflect the prevailing attitude of the American people, nearly three-quarters of whom indicated in a 1972 Gallup survey that they believed that "birth control information, services and counseling should be made available to unmarried teenagers who are sexually active." (15) It is also reflected in the recommendation of the U.S. Commission on Population Growth and the American Future that "birth control information be made available to teenagers i n appropriate facilities sensitive to their needs and concerns"; (16) in the actions of the physician groups referred to earlier; and in the American Bar Association's resolution calling for the development of "affirmative legislation which will permit minors to receive contraceptive information and services." (17)

Teenagers and Abortion

As with contraception, and medical care in general, minors have encountered considerable difficulty in obtaining legal termination of unwanted pregnancy without parental consent. The U.S. Supreme Court decisions in Roe v. Wade and Doe v. Bolton in January 1973 have, however, to some extent, resulted in increased access of teenagers to legal abortion services. (18) Even before these decisions, the liberalization of abortion laws in several states was associated with a decline in the teenage illegitimate birth rate in 1971. Following years of steady increase in the 1960s, this decline has been attributed in part to the impact of legal abortion. (19)

The U.S. Supreme Court held in Roe and Doe that the right of privacy under the Fourteenth Amendment "is broad enough to encompass a woman's decision whether or not to terminate her pregnancy," and that the Constitution permits only limited restrictions of abortion depending upon the stage of pregnancy reached. Specifically, the Court held that the only limitation that may be imposed on abortion in the first trimester of pregnancy is the requirement that the abortion be performed by a physician; and in the second trimester, regulations may be imposed only if they are designed to protect the health of the pregnant woman. Not until the fetus is viable may the state regulate abortion for protection of the fetus; and such regulation must include exceptions where the pregnant woman s life or health would be at risk.

In Roe and Doe, the Court expressly left open the issue of the validity of parental consent requirements in abortion statutes. (20) Since, in most states, 18-year-olds have attained majority, women may consent for abortion at 18 in all of the states except Nebraska and Wyoming. But the girl who is younger than 18 and pregnant may face formidable obstacles in obtaining abortion without parental consent. Moreover, her need for medical services and her fear of adverse parental reaction are likely to be even greater than those of a teenager seeking contraception. As we have noted, the pediatric "Bill of Rights," adopted by the board of the National Association of Children's Hospitals and Related Institutions, specifically includes the minor's right to seek out and obtain professional medical assistance in counseling for and procurement of abortions without parental consent.

Although no state statute specifically prohibits provision of contraceptive services to minors, (++) a number of states specifically require parental consent for legal abortion for girls younger than 18. (*)

Some of the statutes which allow teenagers younger than 18 to consent for contraceptive services or for pregnancy-related care specifically exclude abortion. (+) Even before Roe and Doe were decided, statutes in 11 states (++) contained specific requirements of parental consent for abortion of a minor. (21) (All these statutes, however, were invalidated for other reasons under the Supreme Court's decisions in Roe and Doe.) Even in the absence of a specific statute, it has been argued that parental consent for abortion is required under the old common law rule applicable to medical treatment in general. It has been held, however, that a parent cannot compel a 16-year-old daughter to have an abortion against her will. (22) It must follow that a similarly situated minor should not be compelled to bear a child she does not want.

The most recent legislative action, taken by the District of Columbia City Council, liberalizes consent requirements for minors for abortion and all other medical services. On August 20, 1974 the Council unanimously adopted the Minors Health Consent Regulation which provides that minors aged 18 or older may consent for any health service, and that "a minor of any age may consent to medical services which he or she requests for the prevention, diagnosis and/or treatment of (1) pregnancy or its lawful termination (2) substance abuse, including drug and alcohol abuse and (3) psychological disturbance." The regulation excludes from the self-consent provision consent for sterilization. (The age of majority in the District is 21.)

Since Roe and Doe, numerous legal attacks have been launched upon parental consent requirements for abortion, based on constitutional grounds. Court decisions in recent years have recognized that minors have constitutional rights and the right of privacy has been held a constitutional right that minors may assert. (23) Specific statutory requirements of parental consent for abortion have been held unconstitutional by federal district courts in Florida (24) and Utah (25) and are being challenged elsewhere. (26) The Florida court based its decision, in effect, on an improper delegation of state power. It held that if the state is prevented by Roe and Doe from limiting the grounds upon which a woman can obtain an abortion, the state cannot grant that power to her parents. An expedited appeal to the U.S. Supreme Court was rejected on procedural grounds, (27) but an appeal to the federal circuit court of appeals is pending at this writing, so the case may still get to the U.S. Supreme Court in due course.

On July 12, 1974, Pennsylvania Governor Milton J. Shapp vetoed an abortion bill that had been approved by the legislature. In his veto message, Governor Shapp pointed out that the bill's requirement of parental consent for abortion of an unmarried woman younger than 18 or spousal consent if she is married was unconstitutional under the Supreme Court's abortion decisions. He said the bill would have unconstitutionally interfered with the woman's right, in consultation with her physician, to have an abortion in the first trimester of pregnancy free of state regulation. (28) Nevertheless, the legislature overrode the governor's veto and the bill became law on September 10, 1974, following House action.

Specific statutory requirements of parental consent for abortion which do not apply when minors seek other forms of medical treatment involving similar risks are clearly vulnerable to attack on constitutional grounds. This is because they impose greater restrictions on abortion - a fundamental right - than on other comparable medical procedures. In addition, successful attacks have been made on the old common law requirement of parental consent for medical care when that requirement has been invoked in the abortion area.

Thus, the Family Division of the District of Columbia Superior Court held that a 17-year-old girl's mother could not prevent her, on religious grounds, from having an abortion. The court pointed out that the girl's "degree of maturity and knowledge was such that she fully understood the nature of the proceedings, the nature of the operation, how the operation is performed and the effect of such an operation." In those circumstances, the court held that to deny the girl an abortion would be depriving her of a right guaranteed by the Constitution and Bill of Rights. (29) In a New York case, involving a doctor who performed an abortion on a minor without parental consent, a federal judge denied summary judgment for the plaintiff, the girl's father, on the ground that whether the minor "was competent to exercise this right [to terminate her pregnancy] on her own behalf without her parents' consent presents an issue of fact." (30)

The rationale behind the requirement of parental consent for medical care of minors is the fear that minors are not competent to make decisions in their own best interest, and the belief that parents will act in the best interests of their child. Surely, however, it cannot reasonably be said to be in the best interests of a minor woman to endure pregnancy and bear a child against her will.

It therefore seems probable that courts which face the issue will continue to hold that a minor who is old enough and intelligent enough to understand the nature and consequences of abortion has the right to have her pregnancy terminated on her own request, in consultation with her physician.

Teenagers and Voluntary Sterilization

The voluntary sterilization of minors has not been a pressing problem, since adolescents have generally not requested sterilization, a permanent means of birth control, except in the small number of cases where any pregnancy would constitute a serious danger to their health, or where they are carriers of a serious hereditary disease. Thus, a study made by DHEW's Center for Disease Control found that a total of 153 women under age 18 had been sterilized in federally funded family planning programs in 1972 -- or 0.009 percent of all women reported to have received any family planning services under these auspices, and fewer than one percent of all women who had voluntary sterilizations in the program during that year. [31]

The subject of sterilization of minors, however, was publicized widely following the disclosure that federal funds were used for the tubal ligation of two young black adolescents in Montgomery, Alabama, in the summer of 1973. After a lawsuit was filed on behalf of 14-year-old Minnie Reif and her sister, 12-year-old Mary Alice Reif by the Southern Poverty Law Center, [32] alleging that informed consent had not been obtained from the girls or their parents, it was ascertained that federal funds had been used to pay for sterilizations performed on several other black teenagers in Montgomery.

DHEW placed a moratorium on the use of federal funds for sterilizing minors and legally incompetent adults, and issued new guidelines for such sterilizations. These new regulations were successfully challenged in a lawsuit brought by the National Welfare Rights Organization. On March 15, 1974, Federal Judge Gerhard Gesell ruled that under the applicable statutory framework, federal funds could not be used at all to sterilize minors and mentally incompetent adults. [33]

Of the state statutes which specifically authorize minors to consent for their own contraceptive care, those of Georgia, Kentucky, Maryland, Montana and the District of Columbia exclude sterilization. Statutes in Arkansas, Colorado, North Carolina and Tennessee specifically provide that a person must be 18 or married to consent to sterilization; and Virginia requires the consenting person to be 21.

The "mature minor" doctrine has been invoked by the Supreme Court of Washington in a case sustaining the right of an 18-year-old married minor to consent to a vasectomy. [34] That case was decided before the age of majority in Washington was reduced to 18. The court said that age, intelligence, maturity, training, experience, economic independence or lack thereof, general conduct as an adult and freedom from the control of parents were all factors to be considered.

Conclusion

The age of majority in most states has been reduced to 18, and there is a strong nationwide trend toward recognition of the right of those below that age to con- sent for their own medical care. Many states have enacted statutes specifically giving minors the right to consent for their own medical care in sex-related areas such as venereal disease, birth control and pregnancy, where teenagers are exposed to high medical risks. The legislative trend is not so clear with regard to abortion; and several states have adopted laws prohibiting abortion of minors without parental consent. Some of these laws have been successfully challenged in the courts on constitutional grounds, however, and it appears likely that a mature minor's right to abortion without parental consent will be sustained as a matter of constitutional right.

Eve W. Paul is an associate of, and Harriet F. Pilpel and Nancy F. Wechsler are partners in, the law firm of Greenbaum, Wolff and Ernst, which is counsel to Planned Parenthood Federation of America and Planned Parenthood of New York City.

(*.) For women, the age of majority is 18 in all states except Alabama (21 if not married), Alaska (19), Colorado (21), Hawaii (20), Mississippi (21), Missouri (21), Nebraska (19), Pennsylvania (21), South Carolina (21) and Wyoming (19). It is 21 in the District of Columbia.

(+.) All but Alaska (19), Hawaii (20), Missouri (21), Nebraska (19), Wyoming (19).

(++.) All but Nebraska and Wyoming (19).

(ss.) Forty-nine states have statutes which specifically affirm the right of persons under 18 to consent for diagnosis and treatment of venereal disease and in the fiftieth state, Wisconsin, 18-year-olds may consent because they have attained majority.

(**.) An emancipated minor is usually defined as one who lives apart from his parents and is self-supporting. Marriage also emancipates a minor, as does military service. A minor may be emancipated for some purposes and not for others, so that in many states and situations a doctrine of partial emancipation may apply.

(*.) Arkansas, Idaho, Mississippi and New Hampshire.

(+.) Some appear also to fear possible criminal prosecution, although, again, we know of no case in which either a doctor or a layman has been successfully prosecuted under any criminal statute for providing contraceptive information or services to a minor.

(*.) The states are: California, Colorado, Florida, Georgia, Idaho, Illinois, Kentucky, Maine, Maryland, Mississippi, Oregon. Tennessee and Virginia.

(+.) Alaska, Arkansas, Iowa, Kansas, Louisiana, Michigan, New Mexico, New York, Ohio, Oklahoma, West Virginia and Wyoming.

(++.) New York forbids dispensing by pharmacists of contraceptives to persons younger than 16; but this section does not apply to doctors. The Utah Supreme Court declared that distribution of contraceptives to minors could be viewed as contributing to their delinquency (see reference 11), but we know of no conviction of a doctor or layman upon such grounds.

(*.) State legislatures in Florida, Indiana, Louisiana, Nebraska, Nevada, South Dakota and Utah reacted to Roe and Doe by passing laws expressly requiring parental consent for abortions for all unmarried minors. (See: R. Wasserman, "Note, Implications of the Abortion Decisions: Post Roe and Doe Litigation and Legislation," Columbia Law Review, 74:237, 1974, at 246 n. -67.) Kentucky adopted a requirement of parental consent for abortions after the first trimester for all minors; Montana and Utah adopted a requirement of notification to the girl's parents. On August 2, 1974, the Massachusetts legislature overrode n governor's veto and passed a law which requires that an unmarried girl under 18 must obtain the consent of both parents, if living, or an order from a Superior Court judge. A South Carolina statute passed July 18, 1974 requires a parent or guardian consent for an unmarried girl under 16. Similar statutes applying to unmarried girls under 18 were passed by the Ohio and Missouri legislatures in June 1 974.

(+.) Such exclusions are found in the statutes of Arkansas, Georgia, Kentucky, Missouri, Montana, Oregon. Texas and Virginia. (Where not specifically excluded, pregnancy-related treatment has been held in at least one case to include abortion - Bollard v. Anderson, 4 Cal. 3rd 873. 484 P. 2d 1345 (1971).)

(++.) Alaska, Arkansas, Colorado, Delaware, Florida, New Mexico, North Carolina, Oregon, South Carolina, Virginia and Washington. The Delaware and North Carolina statutes were modified by later laws eliminating the consent requirement.

References

(1.) Modugno v. Monsey Medical Center, U.S. D. Ct., S.D.N.Y., Civil Action No. 73 C 230. See also In re P. 1., discussed below.

(2.) Smith v. Seibly, 72 Wash. 2d 16, 431 P. 2d, 719 (1967).

(3.) Lacey v. Laird, 166 Ohio St. 12, 139 N.E. 2d 25(1956).

(4.) Younts v. St. Francis Hospital, 205 Kan. 292, 469 P. 2d 330 (1970).

(5.) Bakker v. Welsh, 144 Mich. 632, 108 N.W. 94 (1906); and Bishop v. Shurly, 237 Mich. 76, 211 N.W. 75(1926).

(6.) M. Zelnik and J. F. Kantner, "The Resolution of Teenage First Pregnancies," Family Planning Perspectives, 6:74, 1974.

(7.) J. A. Menken, "Teenage Childbearing: Its Medical Aspects and Implications for the United States Population," in Commission on Population Growth and the American Future, Demographic and Social Aspects of Population Growth, C. F. Westoff and B. Parke, Jr., eds., Vol. 1 of Commission Research Reports, U.S. Government Printing Office, Washington, D.C. (GPO), 1972, p.331.

(8.) National Association of Children's Hospitals and Related Institutions, "The Pediatric Bill of Rights," Feb. 25, 1974 (offset).

(9.) National Center for Family Planning Services, DHEW, Family Planning, Contraception, and Voluntary Sterilization: An Analysis of Laws and Policies in the United States, Each State and Jurisdiction (as of September 1971), GPO Stock No. 1731.002, 1974, p. 70.

(10.) Mont. Reg. Sess. 1974 New Laws, p. 603, Ch. 312, Laws 1974, House Bill No. 999.

(11.) Doe v. Planned Parenthood Association, 29 Utah 2d 356, 510 P. 2d75 (1973).

(12.) Cert. denied, 414 U.S. 505 (1973).

(13.) Maley, et al. v. Planned Parenthood of Minnesota, Inc., Minn. Dist Ct., Third Judicial District, File No. 37769 (1973).

(14.) H. F. Pilpel and N. F. Wechsler, "Birth Control, Teenagers and the Law," Family Planning Perspectives, Vol. 1, No. 1, 1969, p. 29.

(15.) R. Pomeroy and L. C. Landman, "Public Opinion Trends: Elective Abortion and Birth Control Services to Teenagers," Family Planning Perspectives, Vol. 4, No. 4, 1972, p. 44.

(16.) Commission on Population Growth and the American Future, Population and the American Future, GPO; 1972, p. 109.

(17.) American Bar Association, resolution on contraceptive information and services, approved at annual meeting, Washington, D.C., Aug. 1973.

(18.) Roe v. Wade, 410 U.S. 113 (1973); and Doe v. Bolton, 410 U.S. 179 (1973).

(19.) J. Sklar and B. Berkov, "Teenage Family Formation in Postwar America," Family Planning Perspectives, 6:80, 1974.

(20.) Roe v. Wade, 410 U.S. at 165 n. 67.

(21.) H. F. Pilpel and J. Zuckerman, "Abortion and the Rights of Minors," Case Western Re. serve Law Review, 23:779, 1972.

(22.) In re Smith, 16 Md. App. 209, 295 A. 2d 238 (1972).

(23.) In re Gault, 387 U.S. 1 (1967); Tinker v. Des Moines Community School, 393 U.S. 503 (1969); and Merriken v. Cresssnan, 364 F. Supp. 913 (E. D. Pa., 1973).

(24.) Coe v. Gerstein, Civil Action No. 51.1250 (S.D.Fla.,Aug. 13, 1973).

(25.) Doe v. Rampton, 366 F. Supp. 189 (D Utah, 1973). After this decision Utah adopted a new abortion statute requiring the physician to notify, if possible, the parents of a minor woman upon whom he performs an abortion.

(26.) State of Washington v. Koome, Wash. S. Ct. No. 42645. So far as the writers know, this is the only case where a physician has been prosecuted for violation of the parental consent requirements of a state abortion statute. The case is currently on appeal in the Supreme Court of Washington.

(27.) 42 U.S. Law Week, 3666, Case No. 73 1157, June 3, 1974.

(28.) Statement by Governor Milton J. Shapp on vetoing S.B. 1318, press release, Office of the Governor, Commonwealth of Pennsylvania, July 12, 1974.

(29.) In reP. J. (D.C. Super. Ct., Feb. 6, 1973) reported in 12 Criminal Law Reporter, 2549 (March 28, 1973); and 101 Daily Washing. tonian Law Reporter, 613 (April 3, 1973).

(30.) Modugno v. Monsey Medical Center, U.S. Dist. Ct., S.D.N.Y., Civil Action No. 73 C 230.

(31.) C. W. Tyler, Jr., "The Sterilization of Minors and Others Legally Incapable of Con. senting: A Review of Current Information," Washington, D.C., Dec. 28,1973 (mimeo).

(32.) Relf, et al. v. Weinberger, et al., Civil Action No. 73.1557, U.S. Dist. Ct., Washington, D.C., March 15, 1974.

(33.) National Welfare Rights Organization v. Weinberger, et al., Civil Action No. 74.243, U.S. Dist. Ct., Washington, D.C., March 15, 1974.

(34.) Smith v. Seibly, 72 Wash. 2d 16, 431 P. 2d 719 (1967).

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Table 1

Ages at which state legislation, court action, or attorneys general
opinions have specifically affirmed the right of individuals to consent
for their own medical treatment: for medical care in general, for
contraceptive services, for examination and treatment for pregnancy and
venereal disease, and for abortion; and age of majority, as of June 1974
(X = any age) (*)

State     Age of             May consent for medical care in
          majority                       general
                     No                 If married       In
                     limitation         (M) or           emergency
                                        emancipated (E)

Ala.      21 (18M)   14                 E (9), M         X
Alaska    19, MF     19                 MF               19
Ariz.     18         18                 E, M             X (10)
Ark.      18F        X (2,4)            E, M             X
Calif.    18         18                 15E (6), M       X
Colo.     21         18                 15E (16), M      18
Conn.     18         18                 E, M             18
Del.      18         18                 E, M             18
Fla.      18         18                 E, M             X
Ga.       18         18 (3)             M (3)            X
Hawaii    20         20                 20               20
Idaho     18         18                 18               18
Ill.      18 (1)     18                 M (7)            X
Ind.      18         18                 E, M             X
Iowa      18, M      18                 E, M             X
Kans.     18         X (4), 16 (5)      18               16
Ky.       18         18                 E, M (8)         X
La.       18, M      X (21)             M                X
Maine     18         18                 E                X
Md.       18         18                 M (8)            X
Mass.     18         18                 18               X
Mich.     18         X (4)              E, M             X
Minn.     18         18                 E (6), M (8)     X
Miss.     21         X (4)              E, M             X
Mo.       21         21                 E, M (3)         21
Mont.     18         X (23)             E, M (7)         X
Nebr.     19, M      19                 M                19
Nev.      18         18                 E, M             X (10)
N. H.     18         X (4)              E, M             X (4)
N. J.     18         18                 E, M (7)         18
N. Mex.   18         18                 E, M             X (10)
N. Y.     18         18                 E, M (8)         X
N. C.     18         18                 E, M             X
N. Dak.   18         18                 E, M             18
Ohio      18         X (4)              18               X (4)
Okia.     18         18                 E, M             X
Oreg.     18 (1), M  15                 M                15
Pa.       21         18                 E (9), M         X
R. I.     18         18                 E                16, M
S. C.     21         16 (22)            E, M             X
S. Dak.   18         18                 E, M             18
Tenn.     18         18                 18               18
Tex.      18         18                 16E, M           X
Utah      18F, M     18                 M                X
Vt.       18         18                 E, M             18
Va.       18         18 (3)             E                18
Wash.     18         18                 E                18
W. Va.    18         18                 18               X
Wis.      18         18                 E, M             18
Wyo.      19         19                 19               19
D. C.     21         18 (3)             E, M (3)         X

Total
At 18     40         35                 6                13
<18                  11                 43               32

State                     May consent for:

          Contraception  Pregnancy-  VD        Abortion
                         connected   care
                         care

Ala.      14             X           X         14
Alaska    19 (11,12)     15 (17)     X         18
Ariz.     18             18          X         18
Ark.      X (2,4,12)     X (14)      X         18
Calif.    15 (13)        X           12        X
Calo.     X (2)          18          X         18
Conn.     18             18          X (18)    18
Del.      18             12          12        12
Fla.      X (20)         18          X         X
Ga.       XF (14,3)      X (14)      X         18
Hawaii    20             14          14        14
Idaho     X (4)          18          14        18
Ill.      X (15)         X           12        X
Ind.      18             18          X         18
Iowa      18 (12)        18          16        18
Kans.     X (12,14)      X           X         X (4)
Ky.       X (3,14)       X (14)      X         18
La.       18 (12)        18          X         18
Maine     X (23)         18          X         18
Md.       X (3)          X           X         18
Mass.     18             18          X (19)    18
Mich.     X (4,12)       X (4)       X         X (4)
Minn.     18             X           X         X
Miss.     X (16)         X           X         X (4)
Mo.       21             X (14)      X         18
Mont.     18             X (14)      X         18 (27)
Nebr.     19             19          X         19
Nev.      18             18          X         18
N. H.     X (4)          X (4)       14        X (4)
N. J.     18             X           X         X
N. Mex.   18 (12)        X (17)      X         18
N. Y.     16 (12,24)     X (4)       X         X (4,25)
N. C.     18             18          X         18
N. Dak.   18             18          14        18
Ohio      X (12,4)       X (4)       X         18
Okia.     18 (12)        18          X         18
Oreg.     15 (14)        15 (14)     12        18
Pa.       X (26)         X           X         18
R. I.     18             18          X         18
S. C.     16             16          X         16
S. Dak.   18             18          X         18
Tenn.     X (3)          18          X         18
Tex.      18             X (14)      X         18
Utah      18 F           X           X         X (27)
Vt.       18             18          12        18
Va.       X (3,14)       X (14)      X         18
Wash.     18             18          14        18
W. Va.    18 (12)        18          X         18
Wis.      18             18          18        18
Wyo.      19 (12)        19          X         19
D. C.     X (3)          X (3)       X         X

Total
At 18     23             21          1         33
<18       23             28          50        16

(*)The fact that no affirmative legislation, court decision or attorney
general's opinion has been found in a particular state does not mean
that some or even all categories of minors below the ages shown in the
table do not have the right to obtain some or all medical services on
their own consent.

Note: Because of reporting lags, the table probably does not include all
applicable legislation, cases and attorneys general opinions for 1974.

M = Married;

F = Female;

E = Emancipated;

(1)For purposes of signing contracts.

(2)Excluding voluntary sterilization if under 18 and unmarried.

(3)Excluding voluntary sterilization.

(4)If mature enough to understand the nature and consequences of the
treatment. See discussion in text (p. 142) of the "mature minor
doctrine."

(5)If parent not immediately available.

(6)Emancipated defined as living apart from parents and managing own
financial affairs.

(7)And/or pregnant.

(8)Or parent.

(9)Emancipated defined as a high school graduate, a parent or pregnant.

(10)If no parent available, others may consent in loco parentis.

(11)Minors may get information on written request.

(12)Comprehensive family planning law permits (or does not exclude)
services to minors without parental consent.

(13)If a present or potential welfare recipient.

(14)Excluding abortion.

(15)If referred by clergyman, physician or Planned Parenthood or if
"failure to provide such services would create a serious health hazard."

(16)If referred by clergyman, physician, family planning clinic, school
or institution of higher learning or any state or local government
agency.

(17)Examination only.

(18)In public health agencies, public or private hospitals or clinics.

(19)In publicity maintained facilities.

(20)If married or prgnant or "may suffer, in the opinion of the
physician, probable health hazards if such services are not provided."
Surgical services excluded.

(21)If minor "is or believes himself to be afflicted with an illness or
disease."

(22)Except for operation essential to health or life.

(23)If physician finds "probable health hazard."

(24)Statute provides that druggists may distribute contraceptives to
minors 16 years of age or older but does not restrict physicians from
prescribing contraceptives for minors of any age.

(25)In New York City, municipal hospitals perform abortions on minors
without parental consent if married, emancipated or at least 17 years
old or if seeking parental consent would endanger the physical or mental
health of the patient.

(26)Minors are being served under a state law which permits doctors to
serve minors of any age if delay in treatment "would increase the risk
to the minor's life or health."

(27)Parent notification, but not consent, is required, where possible.