House
Bill 693 would prevent minors from receiving medical treatment for sexually
transmitted infections, mental health problems, pregnancy prevention and
substance abuse without prior consent from their parents.
These
are all serious medical issues that require time-sensitive and appropriate
care. If left untreated, all of
these conditions may lead to life-threatening situations.
Most
youth will at some point talk to their parents about these concerns, but if
they cannot or will not for whatever reason, it is still essential that they
receive appropriate care. Sexually transmitted infections, mental health issues
and substance abuse problems can lead to death if they are not treated in a
timely nature.
Adolescents will be
less likely to get tested and treated for STDs if they have to get parental
consent.
- A survey of adolescents at two pediatrics practices in North Carolina found that 92% would undergo STD testing if their parents “definitely would not” find out about the test whereas only 35% would undergo STD testing if their parents “definitely would” find out about the test.[1]
There are compelling
public health arguments for promoting STD testing among youth.
- Early diagnosis and treatment are the best hope for preventing new HIV cases. UNC-based research finds early, uninterrupted treatment with anti-retroviral medications reduces new HIV cases by up to 96%.[2]
- In North Carolina, adolescents aged 15-19 make up the second highest rate of chlamydia and gonorrhea infection, and 23% of new HIV cases in our state are among people under age 24. [3]
- Over 50% of youths aged 13-24 with HIV do not know they are infected. [4]
Increased STD rates
in our youth lead to increased public health costs.
- Average lifetime medical costs to treat a person with HIV ranges from $567,000-618,900 with higher costs resulting when HIV is diagnosed late in the disease progression.[5]
Recognizing
the time-sensitive nature of these medical issues, every state in the U.S. allows
teenagers to seek confidential care for the diagnosis and treatment of sexually transmitted infections. 18 of these states allow, but do not require, a physician to
inform a minor’s parents that he or she is seeking or receiving STI services
when the doctor deems it in the minor’s best interests.[6]
With a parental
consent requirement, many adolescents will forgo testing and medical treatment
leading to greater STD transmission to their peers and greater economic costs
to society.
Sometimes,
parents are the reason why a young person needs to seek medical care. In cases
where the minor is emotionally, physically or sexually abused by the parent, it
is critical that the he or she have the ability to access care without the
consent of the parent perpetrator. Each year, there are nearly 70,000 reports of
abuse and neglect – it’s critical that all of these youth have access to health
services.
Public
health policies should always encourage adolescents to seek timely,
professional health care—not impede access to confidential care. This is why the American Academy of Pediatrics and the
American College of Obstetricians and Gynecologists oppose mandatory parental
consent laws.
[1] Carol Ford &
Dana Best, Confidentiality and Adolescents’ Willingness to Consent to Sexually
Transmitted Disease Testing, Archives of Pediatrics & Adolescent Medicine,
Vol. 55, Sept. 2001, 1072.
[2] Cohen et al.,
Prevention of HIV-1 infection with Early Antiretroviral Therapy, N. Eng. J. Med.,365(6):493-505, available at
www.nejm.org/doi/full/10.1056/NEJMoa1105243#t=articleTop.
[3] North Carolina
HIV/STD Quarterly Surveillance Report: Vol. 2012, No. 2, Communicable Disease
Surveillance Unit.
[4] Ibid.
[5] Schackman, et al.,
The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United
States, Med. Care., 2006 Nov.; 44(11):990-7.
[6]
State Policies
in Brief, Overview of Minors’ Consent Laws, Guttmacher Institute, February
2011.
