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Minors' Access to Contraception

Minors are constrained in their ability to consent to medical care. Ideally the minor and his or her parent will agree on the need for contraception, and the parent will authorize the medical care. However, many parents do not want their sons and daughters to use contraceptives because they believe that this availability will encourage sexual activity. Minors may purchase nonprescription contraceptives in all states, and many states explicitly allow mature minors to consent to prescription contraceptives. Physicians also may counsel minors about contraception without parental consent.

Some states do not explicitly allow minors to consent to prescription contraceptives, but no state prohibits minors from receiving prescription contraceptives. The federal family planning legislation (Title X) encourages medical care providers to make contraceptives available to minors. While this legislation has a provision requiring the parents of minor patients to be notified after the minors receive care, the enforcement of this provision has been enjoined by the courts. Ethically, physicians have a duty to respect the privacy of minors. Legally, however, many states allow physicians to breach the physician-patient relationship and notify parents of medical care rendered to their minor children. Currently, no state requires parents to be notified when a minor is prescribed contraception. In general, physicians should respect a minor's privacy, but there are situations when it is advisable to involve her parents--for example, ancillary conditions, such as suicidal tendencies, that are detected as part of the medical encounter. The mere fact of sexual activity does not justify breaching the minor's confidence although it may be grounds for suspecting abuse or neglect if the minor is younger than 14.

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