Hormonal Contraceptive Consent by Minors

Implications for Pharmacists

Geoffrey Mospan, PharmD, BCPS

Disclosures

US Pharmacist. 2018;43(5):22-25. 

In This Article

Consent Requirements for Minors

At the federal level, the Title X Family Planning Program issues grants to clinics across the country that provide family planning and related preventive health services.[2] Adolescents who receive care at one of these federally funded facilities are not required to have their parents' or guardians' consent to obtain hormonal contraceptives or other preconception healthcare services.[3] The clinic is not permitted to notify the minor's parents or guardians about the services received.[3] Additionally, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) contains provisions addressing the issue of minors and the privacy of their health information.

Whether minors can or cannot consent to medical treatment is not within the scope of the HIPAA Privacy Rule, which "addresses access to, and disclosure of, health information, not the underlying treatment."[4] Although the Privacy Rule allows parents access to their child's healthcare records "when such access is not inconsistent with State or other law," there is a notable exception wherein disclosure of the minor's records is not permitted.[5] The parent or legal guardian should not be given access "when the minor is the one who consents to care and the consent of the parent is not required under State or other applicable law."[5] As a result, laws on the state level provide important insight into the rights of minors consenting to hormonal contraceptives.

Almost every state has passed laws or policies that permit minors to consent to contraceptive services.[6] States may allow all minors to consent to hormonal contraceptives or just minors meeting specified characteristics, such as being married or attaining a certain age.[6] Along with the ability to consent to contraceptives, state laws usually include privacy or confidentiality regulations with regard to parental notification.[1] An example of minor-consent laws and confidentiality may be found in the North Carolina statutes: "Any minor may give effective consent to a physician licensed to practice medicine in North Carolina for medical health services for the prevention, diagnosis and treatment of… (ii) pregnancy,"[7] and "The physician shall not notify a parent, legal guardian, person standing in loco parentis, or a legal custodian other than a parent when granted specific authority in a custody order to consent to medical or psychiatric treatment, without the permission of the minor."[8] Pharmacists should always remember to follow the stricter law when federal and state laws conflict.

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