Adolescent consent, privacy laws vary widely across US
Adolescent consent and privacy laws vary widely from state to state and could cause complications in confidentially accessing sensitive health care services, according to researchers.
Their study, published online in Pediatrics, showed that most state laws regarding adolescent consent and privacy do not align with pediatric professional standards of care, such as recommendations provided by the AAP.
“Long-established state laws are often inconsistent in how they address these conflicting objectives, resulting in varying regulations from state to state,” they wrote. “For example, adolescents in some states can consent to their own health care if they have reached a certain age or are parents themselves, and in others, they can only consent to specific types of sensitive health care within the domains of reproductive health, sexually transmitted illnesses, or substance abuse... Although the best clinical practices to support adolescent autonomy should transcend state lines, state law variations make it nearly impossible to provide the privacy protection that is supported by medical societies, including the [AAP], to support adolescent autonomy.”
Study co-author Marianne Sharko, MD, MS, an instructor of population health sciences and pediatrics at Weill Medical College of Cornell University, said in a Healio interview that “no two states had identical laws regarding consent and confidentiality” for adolescent patients. For example, although all 50 states had provisions for consent to manage STDs, those provisions varied depending on the age and the type of minor, whether testing included HIV, and whether confidentiality was protected. Moreover, the regulations were “at times were complex and difficult to interpret.”
Sharko added that although she and her colleagues were “anticipating variability” in the state laws, the degree to which they varied was surprising.
“Many studies have shown that adolescents rely on confidentiality in order to encourage them to access important sensitive health care — reproductive health, mental health and substance use support,” Sharko said. “Especially in today's mental health crisis, which has worsened during [the] COVID-19 pandemic, accessing mental health support has become even more important for the current youth.”
The researchers suggested that health care providers — not policymakers and politicians — “should be the ones determining privacy and confidentiality regulations for adolescent patients.”