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 their
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 without parental consent. Medical care
practitioners 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. Although
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, medical care practitioners have a duty
to respect the privacy of minors. Legally, however, many states allow medical
care practitioners to breach the medical care practitioner–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, medical care practitioners 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.