Topic:
MEDICAL CARE; JUVENILES; INFORMED CONSENT;
Location:
JUVENILES;
Scope:
Connecticut laws/regulations;

OLR Research Report


The Connecticut General Assembly

OFFICE OF LEGISLATIVE RESEARCH




March 22, 1995 95-R-0617

TO:

FROM: John Kasprak, Senior Attorney

RE: Medical Treatment for Minors

You want to know the law on emergency medical treatment of minors, particularly when family members (e.g. grandparents) bring them in for care when the parents are unavailable.

SUMMARY

The traditional common law view was that a minor child could not consent to medical or surgical treatment. A physician was obliged to get the consent of the child's parent or someone standing in place of the parent. The only acceptable exception was an emergency when it was either impractical to obtain parental consent or any delay would unduly endanger the patient's life. Case law on this subject strongly supports this exception; courts hearing such cases often broadly define medical emergencies. In medical emergency cases, the courts have discussed an implied consent to treatment. Permission by the parents or guardian for medical or surgical care is implied by the law, assuming that had the parents known of the situation, they would have authorized treatment. The more urgent the circumstances, the more likely that the courts will find a basis for implied consent. Generally, the issue is examined on a case-by-case basis (see Rozovsky, “Consent to Treatment, A Practical Guide”).

Connecticut law is not particularly detailed concerning the issue of parental consent for the routine or emergency examination of a minor. The public health code provides that “it shall be the responsibility of each hospital to assure that the bylaws or rules and regulations of the medical staff include the requirement that, except in emergency situations, the responsible physical shall obtain proper informed consent as a prerequisite to any procedure or treatment for which it is appropriate (Public Health Code, 19-13-D3(d)(8)). The law does not address the ability of “grandparents” to give consent.

State law does allow a minor to receive care and treatment without parental consent for venereal disease, substance abuse, and mental health. A minor can receive a HIV test without parental consent. In the case of abortion, a woman under age 16 must receive counseling before an abortion which must include the possibility of involving her parents or other family members in her decision.

SPECIFIC STATE LAWS

Venereal Disease

A minor does not need parental consent for treatment of venereal disease (CGS 19a-216). Municipal health departments, state facilities, physicians, and public or private hospitals and clinics may treat a minor for venereal disease without the consent of his parents. These activities must be kept confidential by the physician or health facility, including the sending of a bill for services, except for purposes of reporting cases of venereal disease to local directors of health. These reports are confidential ( 19a-215). But if the minor treated for venereal disease is under 12, the physician or facility must report his name, age, and address to the commissioner of children and families ( 19a-216).

Drug or Alcohol Dependence

Connecticut law also provides for treatment of a minor's drug or alcohol dependence without parental consent. The law provides that “the fact that such minor sought treatment or rehabilitation or that he is receiving such treatment or rehabilitation, shall not be reported or disclosed to the parents or legal guardian of the minor without his consent. The minor may give legal consent to receipt of such treatment and rehabilitation” ( 19a-126h). The minor is personally liable for costs and expenses for treatment.

HIV Testing

State law allows for human immunodeficiency virus (HIV) testing of a minor without the consent of the minor's parents or guardian ( 19a-582). But the law requires the parents' or guardian's consent in order to examine or treat a minor infected with HIV or with AIDS unless the physician determines that (1) notification of the parents or guardian will result in denial of treatment or (2) the minor will not start or continue treatment if the parents or guardian are notified and the minor requests they not be notified ( 19a-592). The minor is personably liable for all costs of services received.

Abortion

The statutes require women under age 16 to receive specific pregnancy information and counseling before obtaining an abortion. As part of the counseling, the counselor must discuss

with the individual the possibility of involving her parents or other adult family members in her decision on the pregnancy. The counselor must also discuss with the women whether she thinks involving her parents would be in her best interest ( 19a-601).

Mental Health

State law permits licensed psychiatrists and psychologists, and certified independent social workers and marital and family therapists to provide a minimum of six outpatient mental health treatment sessions to a minor without his parents' or guardian's consent or notification, under certain conditions. Mental health services can be provided without parental consent or notification if:

1. requiring consent or notification would cause him to reject the treatment;

2. the treatment is clinically indicated;

3. failure to provide it would be seriously detrimental to his well-being;

4. he has knowingly and voluntarily sought it; and

5. he is mature enough to participate in treatment productively, in the provider's opinion ( 19a-14c).

Emancipated Minor

An “emancipated minor” ( 46b-150) can consent to any medical treatment. Such a minor must be at least 16 years of age.

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