Thursday, May 26, 2005

My Opinions

Issues of the Day Part II

Well, yesterday's post seemed to spark some conversation and strangely some of us are not as far apart as we seem. So I thought I would try another day and see if we can't spark some controversy or conversation.

Parental/Guardian Consent for Abortion

I believe that children under the age of consent should have parental consent whenever medical procedures are performed and whenever medical circumstances allow. As a person that works in the medical field, we cannot provide medical equipment, medicine, much less an invasive procedure, including an IV, on anyone under the age of 18 or legal consent per state laws. The only circumstances that allow it is in medical emergencies where life and death are at issue.

We cannot even have a child under the age of legal consent sign documents accepting delivery of relatively benign medical equipment like oxygen because it is a "legend" item (ie, prescribed by a physician). We certainly cannot have them sign legal or financial documents on behalf of themselves or even on behalf of their parent who may be receiving the services.

As one friend recently said to me, "the school nurse can't even administer an asprin without parental consent". So, why would we allow an under aged person receive an abortion without consent?

This is not solely an issue of government power deciding via a federal or state law. As you must know, in the court of law, an under aged person cannot consent to a number of things, including sex (ie, statutory rape if the other participant is above the age of consent). In lawsuits regarding medical mal-practice, even if the doctor had the child's name signed in blood on documents consenting to treatment, it would be thrown out in every other case.

Except this one.

The only exceptions I can think of denying a parent parental consent is in the case of incest or other abuse. In which case, I believe that it is a legal/criminal matter and even then, the mother or uninvolved parent (assuming it is usually the mother) could still give consent. Or, where the parents may be deemed unsuitable as guardians. In which case, I believe the state should and would be involved in determining a suitable guardian who would then have the ability to consent to treatment.

If there is a case where no suitable guardian can be found in a near relative, I believe that outside sources could be brought in and ask the courts for an emergency hearing to determine the necessity of guardianship and the medical imperative.

I do recall the recent incident of a 13 year old who ran away from foster care and came back pregnant. Technically, she was in state custody and the state would not consent to the abortion.

I'm not sure which is worse, having a 13 year old with a baby or having one get an abortion.

Yes, I know that it happens today (and at some fairly alarming rates), but I have to say that an abortion has not only medical effects but emotional as well. I do have a friend who had an abortion between her two children's birth. It's been almost ten years since then, but I recall several times over the years where she wondered what her other child would have been like had she not done so. So, I can imagine the trauma of being 13 or 15 and having these questions and issues and not having support. I've seen the "offered" counciling from planned parenthood. If it's asked for , it can be had, but does anyone think a 13 or 15 year old who can't or won't seek parental consent will actually come back for this counciling?

My friend was an adult and didn't. I could see how it bothered her. Maybe some could be blase enough to simply treat it as the removal of cells, but I have to say that pregnancy and the idea of a living being growing inside of a woman by far usually creates a kind of bond or idea about motherhood and decisions to terminate can be tough and play on the person's mind for years. It would seem that parental consent has three important parts to play:

1) Legal as all medical procedures are guided by this principal and protects both the patient and the physician.

2) Support because it is a tough decision and a pregnant child already has many worries on their mind.

3) Doesn't the parent have the right to know and to intercede if their child is having unsafe and unprotected sex?

I know the last two are subjective and dependent on the child's home, but I believe that, while there may be some recriminations, by far, familial support plays a role in child development and certainly, if we should not be interfering in other issues of parental rights, we should not be interfering with this one. I might also mention that pregnant 13 and 15 year olds (just using those ages as examples) don't all come from disadvantaged or troubled homes.

I also believe that pre and post counciling should be mandatory for underaged children who have this procedure. That, I wouldn't demand, but think it's a good idea.

But the first issue, coming from a health compliance background, is a matter of previously set legal precedent and has a puprose that does not include embarassing or traumatizing a pregnant teen, but is there to protect everyone involved, medically, legally and financially.


Cigarette Smoking Man from the X-Files said...

Maybe they figure that if the statutory age of consent for the act of getting pregnant didn't work, why bother with the same charade for the process of dealing with the result?

Scott from Oregon said...

I have seen evidence of deep scarring mentally from the abortion choice. I have seen other women handle the choice with a matter of factness and rationality. In my more malignant moods, I imagine that a solution to much of this would be a simple requirement that all mothers who terminate be required to 'see' what it is they have had removed from them. The later the term, the more profound the experience, and, hopefully, the more impact made on this person to abort the abortion route the second time....

Ahhh, but that would be in my Utopian universe....

As for underaged kids and their parents, it is such a case by case argument that one blanket leaves many cold toes.....

Kat said...

I know where you're coming from cig, but I think there are legal issues that, coupled with the age, preclude it as a charade. Not all abortions go well, even in this modern age of medical miracles. If I was a doctor, i'd be demanding a legal guardian consent to treatment, if only to protect myself from being sued into a bottomless pit and possibly losing my license. my utopian universe, they'd have to see what the abortion looks like BEFORE they consented to the abortion.

I'd agree on "case by case" in regards to the exceptions I was talking about, but I have to say, the legal precedent for consenting to medical treatment has already been set and seems like a good base line to start from.

See my comment to ciggy. It ain't all about the patient, but there are medical risks and I don't think these should be treated lightly for the sake of "privacy". In normal medical setting, the parent/guardian has a right to know information about their child. The "who can know" automatically extends to them.

My thoughts are that we should use the existing baseline precedent and do exceptions on a case by case basis. And, since people will abuse exceptions, there should be some precedents set as to what constitutes the "exceptions".

cjufnf said...

From Kat: " my utopian universe, they'd have to see what the abortion looks like BEFORE they consented to the abortion."

Hey! That reminds me of high school. In religion class during sophomore year (I went to a private, Catholic school), we had to watch actual videos of abortions. Never too pleasant, especially when your religion class was right before lunch.

Jim said...

Not that I consider it a bad idea to require parental consent, but one problem with some of your proposed methods of handling exceptions might be speed. Courts can be slow at times, so how long would it take to appoint a guardian, etc. in the case of incest or abuse?

I got a speeding ticket last year and my court date was three months later--keep in mind that's a court the government makes money on! If the notion of making some bucks doesn't spur them to act with some alacrity, what will?

Kat said...

Jim..i'm thinking there is always "emergency requests for a hearing on guardianship". These happen pretty often in the world of child protective services and probably could apply here.

I'm also thinking that issues regarding unsuitable parents needing their guardianship rejected isn't that frequent and probably wouldn't add a significant burden. Other than that, it might be necessary if that is the whole reason the chic is pregnant in the first place. Could be a good way of catching these "behind closed doors" people trying to avoid prosecution for abusing or pimping their kids.