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Your Health and the Law. A Guide for Teens Fourth Edition. Purpose. Provide broad guidelines on minors’ rights Empower teens to participate in own care Offer resources for health concerns Caution : Law is always changing. 2. Rights and Responsibilities. Parents Minors Health providers

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Your Health and the Law

A Guide for Teens

Fourth Edition


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Purpose

  • Provide broad guidelines on minors’ rights

  • Empower teens to participate in own care

  • Offer resources for health concerns

  • Caution: Law is always changing

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Rights and Responsibilities

  • Parents

  • Minors

  • Health providers

  • Educators

  • Courts

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What is a minor?

  • Under Ohio law, any person who is under the age of 18 is considered a minor.

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Who is an Adult?

  • Any person 18 years of age or older, except:

  • Mental or physical disabilities

  • Competency determined by doctor, courts

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Medical Rights of Minors

  • Limited circumstances without parent consent

  • Contract is enforceable

  • Responsible for payment

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Medical Confidentiality

  • Information about the treatment cannot be disclosed without the permission of the person who consented to the care. (the minor or the parent) Including:

  • Doctors’ records

  • School records

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Medical Confidentiality

  • HIPAA sets national privacy standards:

  • Generally does not affect minors’ consent

  • Where Ohio law is unclear, allows doctor to decide

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Medical Confidentiality

When information may be disclosed to others:

  • Local, state, or federal government reporting

  • Third party at risk (STD, HIV)

  • Court proceeding

  • Abuse or danger to minor suspected

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Informed consent

  • Patient understands and voluntarily agrees to a suggested treatment

  • Verbal consent

  • Written consent (best)

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Informed about what?

  • Why the procedure is necessary

  • The nature and purpose of the procedure

  • The risks and benefits of the procedure and any possible alternatives, including no treatment.

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Informed about what?

  • Cost of procedures

  • Post procedure care

  • Second opinion

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Consent- Parents

  • Parents who do not consent to medically necessary care could be charged with neglect or child endangering

  • Parents do not have the right to refuse medical treatment for their child based on their religious beliefs

  • Emergency- do not need parental consent

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What is Emancipation?

  • Minor can legally consent to all of his or her medical care and treatment only.

  • Parents no longer have financial control over the child.

  • **Court ordered emancipation is rare and hard to obtain**

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Emancipation & Ohio Law

  • Only lists emancipation by:

    • Marriage in law

    • Enlisting in the armed services

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Marriage in Ohio

  • Between a man and a woman only

  • A man must be at least 18 and a woman at least 16 years old

  • Female under 18 needs parent consent

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Scenario - Erin

  • Erin asks her doctor for a confidential pregnancy test. Her friend calls later to find out the results for her. Can the doctor disclose the results to Erin’s friend?

  • Not without Erin’s permission. The information is confidential and cannot be disclosed to anyone but Erin.

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Scenario- Nurse Smith

  • Nurse Smith is a school nurse. One of her patients, a 16-year-old, has a bad case of the flu and wants the nurse to call a doctor. Can Nurse Smith give the student’s medical files to the doctor?

  • Probably not. In certain cases, a minor can authorize the disclosure of health information. However, this is generally up to the parents.

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Consent – Summary

Categories of care not needing parental consent:

  • Reproductive health Care

    • Testing and treatment of STDs, family planning, contraception, pregnancy

  • Mental health care

    • Outpatient counseling

  • Eating Disorders

  • Alcohol and Substance Abuse

  • Child and Sexual Abuse

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Consent – Summary

Categories of care needing parental consent:

  • Abortion

    • Exception: Judicial Bypass

  • Mental Health Care

    • Inpatient care

    • Medication

    • Sessions have expired


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Scenario- Maria

  • Maria, who is 16, receives confidential medical treatment and wants to pay for the treatment through her parent’s insurance plan. Will information about her be disclosed to her parents?

  • Maybe. Some information may be disclosed to her parents during the insurance reimbursement process. Maria should ask the insurance company about the risks of disclosure beforehand.

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Minors and Sexual Health

Do not need parental consent for:

  • Testing & treatment of STDs, HIV/AIDS

  • Emergency Contraception (EC) – must be used within 72 hours of intercourse

  • Birth control

  • Pregnancy

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Minors and Sexual Health

Anonymous vs. Confidential Testing:

  • Anonymous: Recorded by code number - most private

  • Confidential: Recorded in patient’s medical record- more easily accessible


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Minors and Sexual Health

Testing & Treatment of STDs, HIV/AIDS:

  • Minors can undergo treatment without parental consent

  • Local clinics exists to provide care to patients who cannot afford to pay for their treatment

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Minors and Sexual Health

HIV/AIDS Legal Requirement in Ohio:

  • An HIV positive person must inform the following people or face felony:

    • future sexual partners

    • Anyone with whom he/she intends to share a needle

  • Health workers will notify past sexual partners of possible infection

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Scenario - Larry

  • A public health officer tells Larrythat he may have an STD. Can the officer tell Larry who transmitted it?

  • No. The officer can reveal only that Larry is at risk. He or she cannot reveal the name of the contact.


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Minors and Sexual Health

Disclosure of HIV/AIDS information with written release of minor may be made to:

  • Physician

  • Police officer

  • Legal guardian

  • Spouse or sexual partner

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Minors and Sexual Health

Disclosure of HIV/AIDS information- without consent:

  • In emergency for patient or child of patient

  • Government health officer

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Scenario - Kate

  • Kateis 17. She had sex last night with her boyfriend and the condom broke. She is scared that she will get pregnant and her parents will find out. Is there anything she can do?

  • Yes. Kate can use emergency contraception (EC), which is also called “the morning after pill.” EC stops pregnancy from happening if it is used no later than 72 hours after sex. Kate needs a prescription for EC, so she has to see a doctor or go to a clinic. Many clinics that provide birth control also provide EC. She does not need parental consent to get EC, and the services can be provided

  • confidentially.


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Scenario - Sally

  • A 14-year-old girl, Sally, wants to get a prescription for the pill. Does she need parental consent?

  • No. Certain government programs provide for contraceptives, including the pill, to be made available to minors without parental consent. Private physicians may provide contraceptives to their minor patients

  • without parental consent if the patient is mature enough to give his or her own consent.

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Minors and Sexual Health

Abortion:

  • Need parental consent (unless exempt)

    • Judicial Bypass

  • Must meet physician 24 hrs in advance

  • Can’t be forced

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Minors and Sexual Health

Abortion- Judicial Bypass:

  • Must convince Juvenile Court judge that:

    • Minor is mature enough to decide

    • Safety of minor is at risk if parent(s) involved

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Minors and Sexual Health

Abortion:

  • Can’t use state or local public funds to subsidize cost of abortion unless needed to save physical or mental health of the mother

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Scenario- Rebecca

  • Rebecca is 16. She is from New York but is staying in Ohio for the summer for a music program. She has found out that she is pregnant and wants to terminate the pregnancy. Does she need to tell her parents?

  • Yes. Although teens may undergo abortions in New York without parental consent, Rebecca is subject to Ohio law while she is visiting the state. A parent, custodian, or guardian of a person 17 or younger must consent to a minor’s abortion. If a parent will not consent to an abortion, the minor can seek a judicial bypass.

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Minors and Mental Health

Outpatient counseling without consent:

  • At least 14 years old

  • Limited to 6 sessions or 30 days, whichever comes first

  • No medication

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Minors and Mental Health

Exceptions to parental notification:

  • Teen consents

  • The minor is likely to harm someone

  • Provider must first inform minor that the parents are going to be notified

    After treatment limit:

  • Stop care or parental consent needed

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Scenario- Rahim

  • Rahim is 15. He is severely depressed and wants mental health treatment. His parents refuse to allow it. Can the doctor treat Rahim?

  • Yes, if Rahim consents to the treatment.

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Eating Disorders

Symptoms of an eating disorder:

  • Obsession over weight

  • Unhealthy Eating Habits

    • Vomiting

    • Starving

    • Binging

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Eating Disorders

Counseling:

  • Confidential

  • If life threatening or emergency, counselor is required to inform parents

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Consent - Other Care

In Ohio, a minor can also consent to:

  • Alcohol, tobacco, & drug abuse treatment

  • Family planning services

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Minors and Substance Abuse

Alcohol and Drugs:

  • No parental consent needed for treatment

  • Records stay confidential

    Cigarettes and Tobacco:

  • Illegal for minors to use, buy, or obtain tobacco products


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Scenario - Lee

  • Leeis 16. He is thinking about talking to a school counselor about his drinking problem but is scared that his parents will be notified. Can he receive counseling without parental consent?

  • Yes. A minor does not need parental consent

  • to receive counseling. Whether or not the counselor decides to treat Lee, his parents cannot be informed without his permission.


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Minors and Violence

Child Abuse:

  • hitting and yelling that would lead to risk of serious physical or emotional harm

  • Focuses on parent/caretaker’s treatment of minor

  • Responsibility to report suspected abuse

  • Child Abuse Prevention and Treatment Act (CAPTA)

    • you can be prosecuted for knowingly lying about abuse


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Minors and Violence

Sexual Violence:

  • Violation and abuse of a person’s body

  • Most common forms are rape and sexual assault

  • Victims should seek medical care ASAP


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Minors and Violence

Rape:

  • any forced penetration, including intercourse, oral sex and anal sex. Rape is always wrong and should be reported immediately.

    Sexual assault:

  • Inappropriate touching, especially of sexual organs.


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Minors and Violence

Medical Examination of a Minor:

  • Minor can consent to an examination by a hospital physician for the purpose of gathering physical evidence

  • Ohio law provides free emergency room exams to all victims of sexual assault offenses

  • Parental consent not required

  • Hospital must give the parents written notification of the examination


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Summary

  • Minors, who are married or in the armed forces, can consent to all of their own health care.

  • All others can consent to only certain procedures

  • All must understand risks and benefits of treatment to give “informed consent”

  • Adults must protect confidentiality

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Conclusion

“Health is not merely the absence of sickness.”

Hannah Green, Author

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Resources

  • Center for Disease Control

    • 1-800-227-8922.

  • Women, Infants and Children (WIC)

    • 614-644-8006

  • National Domestic Violence Hotline

    • 1-800-799-SAFE

  • National Hopeline Network:

  • 1-800-SUICIDE

    • www.hopeline.com

  • Anorexia Nervosa and Associated Disorders (ANAD)

    • 847-831-3438

    • www.anad.org

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Credits & Ordering

  • Thank You:

    • Friedman-Klarreich Family Foundation

    • ACLU volunteers and student interns

  • Ordering:

    • www.acluohio.org (Publications)

    • (216) 472-2220

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