Reference Card: Minors' Rights to Confidential Reproductive and Sexual Health Care in New York (2013)
Certain minors can consent to any type of health care on their own.
If a minor falls into one or more of the following categories, then he or she can consent to any and all medical treatment confidentially, without involving a parent:
- Emancipated minors: minors who are living on their own and are financially independent of their parents
- Married minors
- Minors who have children
- Mature minors: parental consent may not be required for minors who can give informed consent and are mature enough to make their own health care decisions. The determination of maturity is made by the health care provider, and should be documented in the medical record. Contact legal counsel or the NYCLU if you have questions.
Kinds of confidential health care all minors can consent to on their own include:
REPRODUCTIVE HEALTH CARE
- Pregnancy tests and options counseling
- Abortion services
- Contraceptive care and counseling, including emergency contraception (EC). EC can prevent pregnancy when taken shortly after unprotected sex. As of 2013, EC is available to men and women over-the-counter without age restrictions. For the most up to date information, please call the NYCLU or the National EC Hotline (1-888-NOT-2-LATE).
- Medical, dental, health and hospital services relating to prenatal care
- Labor and delivery services
- All medical care for themselves and their child, once the child is born
TESTING AND TREATMENT FOR SEXUALLY TRANSMITTED INFECTIONS (STIs)
HIV Testing and Treatment
>Informed consent is required
>Anonymous testing is available. This means that the patient’s name is not revealed and the test results cannot be traced to the individual.
>For emergency care; or
>When parental involvement is impossible or could cause harm; and
>When the minor is sufficiently mature to follow the treatment regimen
Test results for STIs and HIV are confidential.
However, positive test results for HIV and certain STIs must be reported to the New York State Department of Health.
DRUG AND ALCOHOL ABUSE CARE
Minors can consent to confidential alcohol and substance abuse counseling
In some cases, minors can consent to medical treatment for substance abuse
MENTAL HEALTH CARE
- Minors can consent to mental health counseling
- Under certain circumstances, minors can consent on their own to inpatient mental health treatment
For more information about providing minors with mental health care or substance abuse treatment, consult with a supervisor or seek legal advice.
EMERGENCY MEDICAL CARE
- Parental consent is not required in cases of emergency
- Records of emergency treatment may be disclosed to a parent unless the provider determines that disclosure would harm the minor patient
- If the minor could have consented to the care on his or her own under the rules above, the care must remain confidential
POST SEXUAL ASSAULT CARE
Minors have the right to consent or refuse to consent to all post-sexual assault care.
- Medical services, even if the minor generally could not consent on her own (e.g., treatment of injuries)
- Forensic evidence collection
- Rape crisis counseling
To facilitate communication, providers should:
- Initiate conservations with adolescents about their right to confidential health care
- Discuss if and how a minor’s parents will be involved in his or her care
- Encourage the adolescent to involve a parent when appropriate
- Establish a trusting relationship with the patient and the parent; discuss confidentiality with each individually
Billing/payment/record keeping can compromise confidentiality.
To minimize the risk of involuntary disclosure, a provider can:
- Inform the minor if the billing process may compromise confidentiality
- Ask the minor patient for alternative contact if she or he does not want to be contacted at home
- Discuss insurance, billing and altenative forms of payment with the minor (cash is the most confidential/safest payment method)
- Educate the billing department about minors’ rights to confidential care and be sensitive to the diagnosis and treatment listed on bills sent home
- Consult with legal counsel before releasing any medical records that might result in harm to the minor patient
Communication and trust are critical. When young people are assured that health care providers will respect their right to confidentiality, they are more likely to seek reproductive and sexual health care.