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COPYRIGHT 1992 The Alan Guttmacher Institute
The findings of the AGI review demonstrate quite dramatically the wide discrepancy that exists between state laws that make a minor's access to abortion conditional upon her willingness to consult with her parents, and state laws that specifically authorize an adolescent to make her own decisions about other types of medical care. State laws mandating parental involvement in the abortion decision also run totally counter to the common approach states take in other important areas of a teenager's life-such as leaving school or placing a child for adoption.
For some advocates of these more stringent approaches to parental involvement in the abortion decision, abortion may seem intrinsically different from other areas in which a minor may make her own decisions because it involves ending a fetus's potential for life, an act some people find morally unacceptable. If abortion is immoral, however, it is no less so if a parent or a judge sanctions the decision. For people who believe that abortion is morally wrong, the issue of parental involvement, logically, should be irrelevant.
Others might contend that abortion is different from other choices a minor may make for herself because it is an irrevocable decision. But so is the decision to have a baby. Few of those who might approve of parents' preventing their teenage daughter from having an abortion would argue that those same parents also have the right to force a teenager to have a baby. Moreover, once a teenager has a child, she is then permitted in most states to make another irrevocable decision: whether to raise the baby herself or place it for adoption. In the case of adoption, while she may have a brief period to change her mind, once the grace period ends, her parental rights are terminated.
Those who believe abortion is morally unacceptable might support laws mandating parental involvement as a way of preventing a minor from having an abortion altogether. Indeed, parental consent or notification requirements are often part of legislation designed to restrict overall access to abortion, and parental involvement statutes are usually introduced by opponents of legal abortion. However, the majority of Americans who support parental consent or notification laws probably do not share these special-interest political goals. Rather, they are more likely to want to ensure that a pregnant teenager receives adult guidance and support when considering all the options available to her, so that she can make a decision that is in her best interests. Yet, the evidence shows that mandatory parental involvement does not accomplish this objective and might actually be contrary to a minor's best interests. What steps can states take to promote a minor's best interests, with respect both to abortion and to other dec isions a teenager may face?
Ensuring Clarification and Consistency in State Laws
The clear trend in state law is to expand the right of a mature minor to make important decisions about his or her own health care and future and the future of his or her child. Statutes are an important means of clarifying and affirming the right of a minor to make important life decisions. As regards medical care, for example, state laws guarantee a minor confidentiality and remove a teenager's possible fear of being "found out" as an obstacle to seeking care and obtaining it without delay. For doctors and other health professionals who treat adolescents, statutes authorizing a minor to consent are a guarantee (except, of course, in cases of negligence) that these health providers can offer services to a teenager without fear of prosecution. (Even where state laws specifically authorize a minor to consent to health care, however, individual providers and health care agencies may refuse to treat a teenager without parental consent, probably largely out of concern about who is responsible for paying for the t reatment.)
Some states have been less diligent than others in clarifying and adopting a consistent approach to teenagers' decision-making authority (see Appendix Table 1). For example, in a number of states, a minor may consent to treatment for STDs, but not to other services related to sexual activity. Certain states authorize a minor to consent to prenatal care and childbirth services, but not to obtain confidential contraceptive services that could enable her to avoid an unplanned pregnancy. States that require parental involvement for abortion often allow a minor to place her child for adoption, without assigning any role in the decision to the grandparents. Some states permit a teenage mother to consent to her child's adoption, but not to medical care for the child. And other states leave a teenage mother in the anomalous position of being able to consent to medical care for her child, but not for herself.
The implementation of a clear and consistent approach to the whole area of legal rights for minors who might be faced with important medical or life decisions would result in two significant benefits: It would assure access to confidential health services for teenagers who feel that they cannot tell their parents about their health problems, thereby encouraging them to seek prompt medical treatment. It would also give health care providers and other professionals working with young people unambiguous guidelines as to the extent to which they can serve minors or act on their instructions, without involving...
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