Analysis of a Health Care Pediatric Ethical and Health Policy Dilemmas
Over the past 30 years, states have expanded minors’ authority to consent to health care, including care related to sexual activity. This trend reflects the 1977 U.S. Supreme Court ruling in Carey v. Population Services International that affirmed the constitutional right to privacy for a minor to obtain contraceptives in all states. It also reflects the recognition that while parental involvement is desirable, many minors will remain sexually active but not seek services such as STI screening and contraceptive care if they have to tell their parents. As a result, confidentiality is vital to ensuring minors’ access to contraceptive and STI screening and treatment services. Even when a state has no relevant policy or case law or an explicit limitation, providers may commonly provide medical care to a mature minor without parental consent, particularly if the state allows a minor to consent to related health services.
When a minor has the legal ability and consent to care, all services provided must remain confidential and cannot be released to third parties including parents and law enforcement. There are some exceptions to the rule of confidentiality, including cases of suspected child abuse and threats by the minor against themselves or others.
· 25 states and the District of Columbia explicitly allow all minors to consent to contraceptive services.
· 24 states explicitly permit minors to consent to contraceptive services in one or more circumstances
· Two states allow minors to consent to contraceptive services if a physician determines that the minor would face a health hazard if she is not provided with contraceptive services.
· 17 states allow a married minor to consent to contraceptive services.
· Four states allow a minor who is a parent to consent.
· Five states allow a minor who is or has ever been pregnant to consent to services.
· Nine states allow a minor to consent if the minor meets other requirements, including being a high school graduate, reaching a minimum age, demonstrating maturity or receiving a referral from a specified professional, such as a physician or member of the clergy.
· Four states have no explicit policy on minors’ authority to consent to contraceptive services. (Guttmacher Institute (2023).
For this assignment you wil
l:
1. Discuss the 1977 U.S. Supreme Court ruling in Carey v. Population Services International that affirmed the constitutional right to privacy for a minor to obtain contraceptives in all states. Explain why this court ruling could be considered an ethical dilemma for some medical providers? Give at least three examples.
2. Discuss your state’s policy on minor consent for birth control and STI screening.
3. Discuss your state’s policy on minor confidentiality.
4. How will these policies impact you as an NP caring for adolescents in the state in which you live and will practice as an NP?
5. Give at least three examples.
