Minors and Where They Can Make Major Decisions

Adolescents may not be able to vote or drink alcohol or buy cigarettes, but in most states, they are able to make several types of health-care decisions for themselves.

Over the past three decades, states have generally viewed minors as capable of making informed decisions about some medical care without their parents’ consent, according to a review of state laws published last November by the Alan Guttmacher Institute, a nonprofit organization that studies reproductive health care issues.

In general, parental consent is required before a minor receives medical treatment, but the exceptions are widespread and include emergency treatment, whether the minor is married, serving in the armed forces or living apart from his or her parents and is self-supporting.

Moreover, 23 states permit minors to consent to contraceptives services while 49 states allow for diagnosis and treatment of sexually transmitted diseases without parental consent. Twenty-seven states grant minors access to prenatal care and delivery services on their own. (In California, minors don’t need parental consent for any of these services.)

States take a firmer stance on whether minors should be able to obtain abortions without their parents’ knowledge, however. Just more than half mandate parental involvement. In California, a law requiring parental consent is being challenged.

In the area of substance abuse, 45 states, including California, permit minors to seek medical care and counseling while 21, including California, grant confidential access to outpatient mental health services.

Other areas of the law also reflect the view that minors should have broad authority to control their own destinies:

* Many states, but not California, according to the AGI report, allow teenagers to drop out of high school without their parents’ permission.

* Eight states, but not California, permit a minor to marry without parental consent under such circumstances as pregnancy or the birth of a child.

* And minors who happen to be parents are given the authority to make any and all decisions regarding their babies; in California and most other states, for example, a juvenile may relinquish her baby for adoption without her parents’ consent.