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.