Care for the mature minor, and when the minor is legally entitled to consent to their

own medical treatment.

Laws that allow minors to consent to medical treatment vary from state to state. In
some ststes minors are allowed to consent to medical therapy based on status ,
such as emancipation , marriage, pregnancy, living apart from parents, and when
given the status of mature minor. The mature minor rule was created in 1967 and is
based on the west Virginia Supreme Court case belcher v,CAMC, which allowed
health careproviders to treat a youth as adult based on an assessment and
documentation of the adolescnts maturity level.According to this decision,a court
determine that a minor is deemed mature , which determination is based on various
factors, including age, ability,experience, education and training degree of matury
and judgment exchibited conduct and demeanor and capacity to understand the risk
and benefits of medical treatment. The process to become a mature minor is known
as judicial bypass and may very from state to state. This exception to prental
consent muse be received from acourt.
In addition , addolescent may consent to medical care of they are considared
emancipated. Emancipation implies that a minor must be of a certain age, must live
apart from his or her parents, and must be self sufficient. Minors are also considered
emancipated if they are self supporting not living at hoe,married, pregnant or a
parent, in the military ,or declared emancipated by the judicial system.
In some states , consent to health care may be based on the type of care the
adolscent is seeking. Examples of the types of helath care services that may be
obtainded without parental conent my include maternity services contrasevtive
management treatment and diagnosis of sexually transmitted infection(HIV)or other
reportable diseases treatment of drug or alcohol problems and care related to sexual
assault or mental health services. These provisions are very important helath-related
issues. Moreover , research shows that adolescents are more likely to seek medical
care if confidentiliaty is protected.

Reportable Diseases
Reporting sexually transmitted infections(STIs), HIV, and other reortabe illnesses can
be stressful for the patient. This may be partycularely stressful for the adolescent.
The information may be reported by the physician or by the physician designated
appointee. All those involved in the oversight of the blood products , including clinical
laboratories or blood banks, are also required to reprts STIs and other reportable
conditions to the states health departement .In addition,it is mandatory that the
information be disclosed to partners.Partner reporting is a way to control the spread
of disease and to ensure

Prompt and proper diagnosis and treatment of all those who may be affected.
Partner notification can occur in either of two ways : by patient referral or by the
department of healt staff. The patient can contact his/her partner(s) for reverral,
diagnostis, and treatment. Alternatively, the partner(s) may be notified and counseled
by department of health staff, if the patient is unwilling to inform them. In the setting
where a patient is unwilling to inform her/his partner(s) of a reportable illness that
places that partner(s) at risk, the healthcare provider has legal and ethical obligation
to inform the partner(s) (if known by the provider) that they are at risk.
Teenage Pregnancy and Confidentialy
Issues regarding teenage pregnancy and consent to disclose information
regarding pregnancy are quite controversial. Laws for reporting vary by state and the
specifics may become quite daunting. For the purposes of that case, focus is limited
to generalities. One must understand the laws pertaining to this issues in the state in
wich her or she practises. In the state of texas, as may be the case in other states, a
clinician is not required to inform teh patient of issues realted to pregnancy of a
minor without the childs consent, but it is not mandatory for adolescent for a
physician to disclose information related to pregnacy parent. However, studies
demonstrate that failure to maintain confidentialy in sensitive healt-related issues
may inhibit appropriate healt care delivery to the adoscent.
In texas, the law does not allow state fund to be used for contraception
without the consent of one or both parent. Moreover, in most state, an adolescent
younger than age 18 years cannot give consent to abortion service without the
consent of one or both parents. This issue has been the subject of political debate
for mant years. Proponents of mandatory consent laws belive that it is the best
interest of the minor for her parent(s) or guardian to be informed of her pregnancy
and decision to obtain abortion service, stating that by doing so, communication
among adult and child may be improved.
Opponents of these laws, however, see them as a threat to the well being of
young women by forcing them to seek abortion service form unlicensed facilities,
crossing state lines to obtain abortions, and increasingmedical risk. The risk to young
women may be increased by enforcing mandatory wait periods, wich could mean
having abortions later in pregnancy that desired.
Currently, only six states do not require consent form parents to obtain
abortions sevices. In a state in wich consent is required, there arre some legal
alternative for young women. For example, if an adolescent is considered
emancipated, the consent form parents or guardians is not required. Waivers of
concent (judicial bypass) may also be obtained through the judicial system.

Conclusion
Pregnancy-related care, abortion sevices, and reportable illness are complex
and clinician should seek legal advice when appriviate. However, in general, it is
preferable to protect the confidentiality of the minor unless it is un reasonable or
unsafe to do so. It is also important to educate teens and parents of the importance
of open communication and issues related to confidentiality in medical care.