Public Health Law Map - Beta 5 - Medical and Public Health Law Site

that HIV is less of a threat than a greasy breakfast. This does not mean that medical
care practitioners should refuse to prescribe oral contraceptives for women who are
not in long-term, monogamous relationships. It does mean that the medical care
practitioner must take care that warnings about HIV are not lost in the general noise
of good health tips and recommendations that are given each patient. Patients who
engage in high- risk sexual activity must be helped to understand the seriousness of
the threat of HIV infection. This information should be reiterated whenever
contraception is discussed or a prescription for oral contraceptives is refilled.
6. Minors’ Access to Contraception
Minors are constrained in their ability to consent to medical care. Ideally the minor
and his or her parent will agree on the need for contraception, and the parent will
authorize the medical care. However, many parents do not want their sons and
daughters to use contraceptives because they believe that their availability will
encourage sexual activity. Minors may purchase nonprescription contraceptives in all
states, and many states explicitly allow mature minors to consent to prescription
contraceptives without parental consent. Medical care practitioners also may counsel
minors about contraception without parental consent.
Some states do not explicitly allow minors to consent to prescription contraceptives,
but no state prohibits minors from receiving prescription contraceptives. The federal
family planning legislation (Title X) encourages medical care providers to make
contraceptives available to minors. Although this legislation has a provision requiring
the parents of minor patients to be notified after the minors receive care, the
enforcement of this provision has been enjoined by the courts. Ethically, medical
care practitioners have a duty to respect the privacy of minors. Legally, however,
many states allow medical care practitioners to breach the medical care practitioner–
patient relationship and notify parents of medical care rendered to their minor
children. Currently, no state requires parents to be notified when a minor is
prescribed contraception. In general, medical care practitioners should respect a
minor’s privacy, but there are situations when it is advisable to involve her parents—
for example, ancillary conditions, such as suicidal tendencies, that are detected as
part of the medical encounter. The mere fact of sexual activity does not justify
breaching the minor’s confidence although it may be grounds for suspecting abuse or
neglect if the minor is younger than 14.
7. Medical Issues in Contraception for Minors
Contraceptives should be prescribed only if medically indicated and desired by the
minor. [ACOG Technical Bulletin 145. The Adolescent Obstetric- Gyncologic
Patient. September 1990.] Most medical care practitioners worry about the risks of
giving minors prescription contraceptives without parental consent. Parental pressure
to force contraceptives on an unwilling minor is a more subtle problem. A minor who
is forced to use contraceptives by a parent or guardian cannot be said to have
voluntarily assumed the risks. If this minor were to suffer a stroke or other serious
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