River Bend Medical Associates is a family medical practice, which means that our staff has the profound joy and privilege to watch the children we treat grow up into young men and women.
But as these growing boys and girls are accompanied by their parents to appointments over the years, there inevitably comes a time where it becomes challenging to address each child’s medical needs, while also satisfying parental concerns.
On a social level, a parent’s interests in their child’s health can cause embarrassment for a child who is struggling to understand how their body is changing and growing.
But there are other serious issues surrounding the medical treatment of a child.
In some circumstances, California law prohibits disclosing medical data to a parent without the child’s consent.
Since the 1990s, California law has afforded minors the right to consent to certain types of medical care, such as the diagnosis and treatment of sexually transmitted diseases, without the consent of their parent or guardian. In recent years, the rights of minors to have access to medical treatment and have their privacy protected have been greatly expanded by the California Legislature.
For instance, in 2010, Governor Schwarzenegger signed Senate Bill 543, “Minor Consent Mental Health Rights,” which granted children 12 years of age and older the right to receive outpatient mental health treatment. Parents must be involved in the child’s treatment, unless a mental health professional deems such involvement inappropriate. However, parents do not have a right to their child’s mental health records, unless the child provides written permission to do so. In 2011, Governor Brown signed Assembly Bill 499, “Minor Consent Reproductive Health Rights,” which granted children at least 12 years of age the right to consent to services for the prevention and/or treatment of sexually transmitted diseases.
Currently, California law provides minors the right to consent to treatment for the following medical concerns (this list is not exhaustive):
- Emergency Medical Services – Providers may provide medical care for minors without the permission of a parent if they believe that the procedure must be performed immediately, and there isn’t enough time to obtain parental consent. Parents typically have the right to review all related medical information.
- Outpatient Mental Health Services – As noted above, minors over the age of 12 may consent to mental health treatment, but not for care involving drugs or other medically significant interventions. Parents must be involved (unless in appropriate), but do not have a right to the related health records without permission from the minor.
- Pregnancy – Minors may receive maternal healthcare without parental permission. Healthcare providers are not permitted to inform parents of such treatments without the minor’s written permission.
- Contraception – A minor may request birth control without parental consent. Parents may not be informed without permission.
- Abortion – A minor may consent to an abortion without parental permission. Parents may not be informed without written permission.
- Sexual Assault – Minors who have been sexually assaulted may consent to any medical care related to the diagnosis, treatment, and collection of medical evidence relating to any sexual assault. Healthcare providers must attempt to inform parents of the assault, unless there’s reasonable cause for believing that a parent committed the assault.
- Rape of a Minor Under 12 Years of Age – A minor under the age of 12 may consent to the diagnosis, treatment, and collection of medical evidence related to their rape. Their parents must be informed, unless a parent is suspected of the crime.
- Rape of a Minor 12 or Older – A minor over the age of 12 has the rights described above. But in addition, their healthcare provider is not allowed to inform a parent of the treatment without the minor’s consent.
- Infectious Disease – Minors at least 12 years of age may consent to treatment of a communicable disease if the disease is one required by law to be reported. A healthcare provider may not inform parents without consent from the minor.
- Sexually Transmitted Diseases – A minor at least 12 years of age may consent to the prevention, diagnosis, or treatment of sexually transmitted diseases (this includes the administration of the HPV vaccine, and testing and/or treatment for HIV and AIDS). Parents may not be informed without the minor’s consent.
- Drug and Alcohol Treatment – A minor at least 12 years of age may consent to drug and alcohol abuse treatment. However, this does not authorize the dispensation of replacement narcotic abuse treatment (e.g. methadone) without the parent’s consent. A minor does not have the right to refuse drug or alcohol treatment if their parent consents to the treatment. Confidentiality varies depending on the circumstances and the facility providing treatment.
We recognize that this is a lot of information to process, and that it may provoke feelings of fear or anger. Our treatment providers have had difficult consultations with parents who perplexed or even infuriated when informed that we could not provide them with details of their child’s medical treatment.
This is because the law has attempted to accommodate the fact that once children start to begin young adults, they naturally start to have a certain amount of bodily autonomy and make choices for themselves. Some of these choices may not be ones that their parents wouldn’t agree with, and an angry parent might attempt to suppress their child’s behavior, rather than take the steps necessary to protect their child’s health.
We aren’t saying that this is what you would do. But it is something that happens, and we are required by law to protect the rights of all minors that we treat.
We strongly encourage all parents to come to us with any questions they might have, so that you can trust our ability to provide your child with the best possible medical care. It can be very difficult to step back and give your child the room they need to grow into a responsible adult. We’ll do anything we can to help support you and your family.