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What Types of Care Can You Receive Without Parental Consent?

What Types of Care Can You Receive Without Parental Consent?

Contraception (Birth Control)

Contraception is used to prevent pregnancy and sexually transmitted infections. It is also used to address a variety of health conditions unrelated to preventing pregnancy. There are many types of contraception, including birth control pills, intrauterine devices (IUD), implants, shots, and condoms. In New York State, you have the right to get birth control from a clinic or your health care provider without involving a parent.

Exception: Sterilization

Even though sterilization is a form of birth control, you are not able to consent to sterilization if you are under the age of 21.

Q&A

QUESTION ...... Carla, who is 14, wants a prescription for birth control pills. Does she need parental consent? .................. ANSWER ...... NO, as long as Carla can give informed consent, meaning she understands her own health and the risks and benefits of the pills, she can get the prescription without her parent.

Emergency Contraception

Emergency contraception (EC), or the “morning after pill,” is a high-dose birth control pill that prevents pregnancy after unprotected sex. EC can only be used to prevent pregnancy. If a person is already pregnant, emergency contraception has no affect on that pregnancy.

Most types of EC are most effective when taken within 72 (sometimes up to 120) hours after unprotected sex. As a rule, the sooner EC is taken following unprotected sex, the more successful it is in preventing pregnancy.

In New York State, you have the right to get emergency contraception without your parents’ consent.

There is no age restriction to get the morning after pill, and you do not need a prescription. It is available at most pharmacies. You can also get emergency contraception from family planning clinics, like Planned Parenthood, or from your health care provider. If you are sexually assaulted and go to the hospital for treatment, your hospital must offer you the morning after pill. You have the right to choose whether or not take the emergency contraception.

Abortion

There are two types of abortions. A medication abortion and an in-clinic abortion. A medication abortion is when a patient is given pills to end a pregnancy. An in-clinic abortion is when a health care provider performs a procedure with medical instruments to end a pregnancy.

You can get an abortion without your parents’ involvement. All information related to an abortion, if you choose to get one, will be kept confidential. Providers will encourage you to discuss this with your parent or guardian to see if it will be helpful to you, but you do not have to.

Q&A

QUESTION ...... Kim is 15. She is from Iowa but is staying in New York for the summer for a dance program. She has found out that she is pregnant and wants to terminate the pregnancy. Does she need parental consent? .................. ANSWER ...... NO. While Kim is in New York, she will be treated according to New York law. She does not need parental consent

Sexually Transmitted Infections

If you provide informed consent, you can be tested and/or treated for a sexually transmitted infection without a parent or guardian’s consent.

New York requires providers to report anonymous cases of syphilis, gonorrhea, and chlamydia to state or local health departments. These health records will be kept confidential.

Consent for Vaccinations

Minors cannot consent on their own to most vaccines. An adult caring for you – a parent, legally appointed guardian, custodian, grandparent, adult sibling, adult aunt or uncle, or another adult who has your parent’s written permission to consent to your care – must consent to your vaccinations.

Exception: HPV

The human papilloma virus (HPV) vaccine is an exception. You may consent to this vaccine on your own.

Q&A

QUESTION ...... Tanya is 15. She thinks she might have herpes, but she doesn’t want to tell her parents. Can she get medical attention without telling them? .................. ANSWER ...... YES. Whether by diagnosis, prescription, or a medical procedure, physicians may treat adolescents for STIs without their parents’ consent. As long as Tanya has the ability to provide informed consent, the doctor may not disclose information about STI services to her parents without her permission.

HIV/AIDS

You can be tested and/or treated for human immunodeficiency virus (HIV) without parental consent. The law requires providers, hospitals, and other centers to offer HIV testing to every person age 13 and older, or younger than 13 if there is evidence or indication of risk activity.

You can also consent to PrEP/PEP. PrEP (Pre-exposure prophylaxis) is medicine taken daily to reduce the risk of contracting HIV. PEP (Post-exposure prophylaxis) is medicine that helps prevent HIV if started within a few days after possible exposure. All information related to this care will be kept confidential.

If you want to get an HIV test and want it to remain completely confidential, it is best to ask for an anonymous HIV test. An anonymous HIV test is a way to test for HIV where your name and contact information is not written down. You are given a numbered testing code that only you know and that you must provide to get your result.

Q&A

QUESTION ...... Raoul, a 16-year-old who lives with his mother, is HIV positive, but has not told his mother. Raoul has now developed an HIV-related illness and wants medical care but will avoid treatment if he is required to tell his mother. Can a health care provider treat Raoul without parental consent? .................. ANSWER ...... YES. A physician may treat Raoul without consulting his parents. However, the physician may want to help Raoul talk to his mother or find a supportive adult whom he can confide in about his situation. .................. QUESTION ...... Jim and Toni, both minors, are considering a sexual relationship. Jim has been sexually active before and believes he may have been exposed to HIV. Toni has never been sexually active before and wants to prevent exposure to HIV. Can Toni consent to using pre-exposure prophylaxis (PrEP) to avoid infection? .................. ANSWER ...... YES. A provider can prescribe PrEP based on Toni’s own informed consent.

Prenatal Care, Labor, and Delivery Services

If you are pregnant, you may consent to medical, dental, health, and hospital services relating to your prenatal care. You can also consent to labor and delivery services. Once your child is born, you as their parent can consent to all medical care for yourself and for your child.

Q&A

QUESTION ...... Priya is pregnant and 15 years old. Can she decide whether to have a cesarean section or a vaginal delivery? .................. ANSWER ...... YES. The health care provider might strongly encourage Priya to seek a supportive adult’s assistance while making this difficult decision, but ultimately, if Priya understands the risks and benefits of the procedures, she can make the decision for herself.

Sexual Assault Care

Sexual assault is any kind of sexual activity that you did not consent to or were unable to consent to. Reasons for being unable to consent include having a mental impairment or being incapacitated (like passing out or being under the influence of drugs and/or alcohol).

Under New York State law, you can consent to or refuse medical care after a sexual assault. This includes:

Morning after pill
Testing and preventive medicine for sexually transmitted infections
Testing and preventive medicine for HIV
Treatment for injuries
Rape crisis counseling
Forensic examination (a rape kit)

Forensic examination or what is commonly called the “rape kit,” is used to collect evidence such as semen, hair, and blood samples for later use if the survivor chooses to file criminal charges. Providers will ask if you want to contact the police and must have your consent before contacting them.

Providers are only required to report sexual assault to the police if:

This was a case of child abuse
You sustained gunshot wounds, life threatening stab wounds, or burns
If the assault occurred where you are receiving mental health care

Remember: the police are not bound by confidentiality and may tell your parent or guardian about the assault, even if you do not want them to know.

Q&A

QUESTION ...... Tee is 15 and goes to the hospital after being raped. They go with a friend but do not want to tell their parents what happened. Can the hospital call their parents or the police? .................. ANSWER ...... NO. Health care providers cannot report a rape to anyone without the patient’s consent, including the police or the victim’s parents.

Mental Health Counseling and Services

Unlike other health care services, mental health services can be difficult to get without a parent or guardian’s consent.

Your right to access mental health services depends on whether you are receiving outpatient care or inpatient care. Outpatient care is when you receive medical treatment without being admitted to a medical facility. Inpatient care is when you stay and get treated in the medical facility.

Outpatient Treatment

A mental health provider practicing in a licensed facility may provide outpatient services to you without your parents’ consent if:

You knowingly and voluntarily seek the services,
The health care provider believes it is necessary to your well-being, and one of the following is true:
- your parent or guardian is not reasonably available, or
- requiring your parent or guardian’s consent or involvement would have a detrimental effect on the course of your treatment, or
- your parent or guardian has refused to give such consent and a health care provider determines that treatment is necessary and in your best interest.

If you are 16 or older, you may be able to receive medication related to your mental health under your own consent as an outpatient.

Q&A

QUESTION ...... Marisol is 15. She is severely depressed and wants mental health treatment. She does not want to tell her parents because she believes they will prevent her from getting help. The physician believes that she needs to be treated. Can the doctor treat Marisol? .................. ANSWER ...... YES, if Marisol consents to the treatment and the doctor determines that involving her parents would have a detrimental effect on her care. Marisol cannot consent on her own to the use of antidepressants until she turns 16, however, and an independent psychiatrist must verify that she has capacity, the medication is in her best interests, and involving her parents would be detrimental to the course of treatment.

Inpatient Treatment

If you are 16 or older, you may be able to admit yourself into a hospital for inpatient care. Legal support will be provided to you and your presence will be reported to the Mental Hygiene Legal Services (MHLS) within three days. The Mental Hygiene Legal Services is a New York State Agency that represents and advocates on behalf of individuals receiving services for a mental disablity. You cannot be forced to stay if you chose to admit yourself unless a provider decides you are a danger to yourself or others. In this case, a court hearing will be held within 72 hours.

When you consent to care, information about the treatment cannot be given to anyone without your permission, but there are some exceptions. If your parent or guardian gave consent, they may ask for your records. If you are over 13 and object to them being given your records, a provider may withhold that information. In addition, your mental health records can be released because of a court order, in a report to health agencies, in notifications to legal service providers, or when you may endanger someone else.

Q&A

QUESTION ...... Can Rahim, who is 15, consent to his own admission for inpatient mental health treatment? .................. ANSWER ...... NO. A minor must be 16 or older to consent to inpatient mental health treatment.

Alcohol and Substance Use Services

In general, parental consent is needed when you are using inpatient, residential, or outpatient services for chemical dependence such as drug or alcohol use.

However, you may be admitted for inpatient, residential, or outpatient treatment related to chemical dependence without your parent or guardian’s involvement and consent, if:

The provider thinks parental involvement will be harmful for your
treatment
Your provider believes that treatment is necessary but your parents
refuse to consent to treatment
Your parents fail or refuse to communicate with your provider
Your provider cannot locate your parents
You are a parent, married, or emancipated

If you are receiving alcohol use or substance use services at a program or facility in New York, your treatment records are held under strict confidentiality. Your records can only be disclosed if they have your written consent, by a court order, or in a medical emergency. This is true for programs that receive federal funding and those that do not.

Q&A

QUESTION ...... Duane is 16. He is thinking about talking to a school substance use counselor about his drinking, but he is scared that his parents will be notified. Can he receive counseling without parental consent? .................. ANSWER ...... PROBABLY. Parental consent is generally not necessary for a minor to receive alcohol counseling, and many schools receive federal funding that requires strict consent and confidentiality rules. Whether or not the counselor decides to treat Duane, the counselor can not disclose information to Duane’s parents without Duane’s permission if the school receives federal funds.

Transgender-Related Health Care

There is no New York law that allows you to consent to trans-related health services, like hormone replacement therapy or gender affirming surgery.

However, if you are a young person who is married, parenting, or emancipated, you can consent to trans-related health services on your own.

You are able to consent to mental health services and counseling in certain settings. Mental health services related to gender identity follow the same rules as general mental health care.

Equal Access to Health Care

New York law prohibits discrimination based on “gender identity or expression.” Everyone has the right to be addressed by their preferred pronouns and names and to receive non-discriminatory care. Trans children and teens are therefore entitled to be treated like any patient with a health care need when they seek services of any kind, including services related to their gender identity.

Part 5

Keeping Your Health Care Confidential