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

side effect, the medical care practitioner could be sued for failure of consent. The
medical care practitioner should talk to the minor alone and attempt to determine if
she truly wants the contraceptive. If the minor is reluctant, the medical care
practitioner should refuse to prescribe a contraceptive for her.
Adolescents are at special risk for STDs:
Adolescent contraceptive practices affect the risk of infections. Many
adolescents never use a method or rely solely on the oral contraceptive.
Whether or not oral contraceptives increase susceptibility to certain
infections, they clearly reduce the impetus to use a barrier method or to
involve males in prevention. Adolescents who decide or can be persuaded to
use barrier methods seldom use them consistently and often use them
incorrectly. IUD are rarely advised for adolescents and should never be
considered for those at high risk for infection or for poor compliance with
close follow-up. [Berman SM, Hein K. Adolescents and STDs. In Holmes,
KK, et al, eds. Sexually Transmitted Diseases. 3rd ed. New York: McGraw-
Hill Professional Publishing; 1998:117–128. ]
Medical care practitioners prescribing contraceptives should provide the minor with
all the information that is usually provided to adult patients. If the contraceptives are
prescribed without parental permission, then it is advised that additional information
be considered and recorded in the medical record:
1. Inquiry should always be made as to the feasibility of parental consent.
2. A full case history, including preexisting sexual activity, should be obtained and
maintained, and it should demonstrate that the medical care practitioner has
considered the “total situation” of the patient.
3. A record should be kept of the “emergency” need and a judgment by the medical
care practitioner that pregnancy would constitute a serious health hazard, one more
serious than the possible disadvantages of the prescription.
4. The minor should be clearly aware of the problems presented and the nature and
consequences of the procedures suggested, including very specific discussions of the
side effects of contraceptive pills if those are to be prescribed. She should be required
to sign a consent form so stating.
5. Where follow-up care is indicated, it should be insisted on. [Holder AR. Legal
Issues in Pediatrics and Adolescent Medicine. 2nd ed. New Haven, CT: Yale
University Press; 1985.]
To this list and the consent form should be added a discussion of the risks of STD
infection, with particular reference to HIV.
D. Sterilization
Legally, a medical care practitioner is held to the same standards of informed consent
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