Minors' Healthcare Rights

A minor is any person under the age of 18. In general, a minor's age determines whether they are able to access health care services independently or if parental or guardian consent is required. Additionally, some services that a minor can access independently can be kept confidential, while others cannot. This can be helpful information in order to plan the most appropriate health services for children and youth.

Consent is an acknowledgement (usually in writing) of any or all of the following:

• The patient understands the treatment he/she will receive.
• The patient authorizes the treatment.
• The patient understands how private information will be shared.

All consent should be informed consent (ORS 677.097). Informed consent for health services should be verbal or in writing and includes: a description of the treatment the patient will receive, a description of alternative treatments and a description of any risks involved with the treatment.

Medical and dental services (Oregon Revised Statute ORS 109.640)

Minors who are 15 years or older are able to consent to medical and dental services without parental consent. This includes hospital care, as well as medical, dental, optometric and surgical diagnostic care. This would include services such as:

• Treatment for illnesses or injuries (colds, sprained ankle);
• Sports or camp physicals;
• Dental visits (check-ups, cleanings, fillings);
• X-ray services;
• Emergency room visits;
• Vision care (except for first time contact lens visit); and
• Immunizations.

Mental health and chemical dependency (ORS 109.675)

A minor who is 14 years or older may access outpatient mental health, drug or alcohol treatment (excluding methadone) without parental consent. These services may include:

• Seeking help from a psychiatrist or psychologist;
• Seeking mental health therapy from a doctor or social worker; and
• Seeking help for drug or alcohol use.

Providers are expected to involve parents by the end of the minor's mental health, drug or alcohol treatment unless:

• The parent refuses involvement;
• Clear clinical indications to the contrary exist and are documented in the treatment record;
• There is identified sexual abuse; or
• The minor has been emancipated and/or separated from the parent for at least 90 days.

For mental health and chemical dependency services, the provider may disclose health information to a minor's parent or guardian per ORS 109.680 if:

• It is clinically appropriate and in the minor's best interests;
• The minor must be admitted to a detoxification program; or
• The minor is at risk of committing suicide and requires hospital admission.
• Although minors age 14 and older can access outpatient mental health and chemical dependency services independently, parents are expected to be involved in their treatment at some point.
• Involvement does not mean that adults always have access to a minor's mental health or chemical dependency records.
• Federal regulation 42 CFR 2.14 states that if a minor is able to self-consent for drug or alcohol treatment, the minor's treatment records cannot be disclosed without the minor's written consent (including to the parent or guardian).

Minors of any age are allowed to access birth control-related information and services as well as testing and treatment for sexually transmitted infections (STIs) including HIV, without parental consent.

Oregon law does not give individuals the ability to consent to sex until the age of 18; however, there are a few important points to consider. Sexual activity is a normal part of development, and according to the 2009 Oregon Healthy Teens Survey, 1 of 11th grade students:

• Forty-eight % have had sexual intercourse.
• Of those, 58% reported using a condom.

Ensuring that young adults have proper resources and information on sexual activity is important for them to make healthy choices.

Oregon law does not give minors a "right" to confidentiality or parents a "right" to disclosure. However, federal law may offer additional protections in some circumstances. When a minor self-consents for health care services, providers are encouraged to use their best clinical judgment in deciding whether to share information with the parent or guardian (ORS 109.650).*‡ However, most people, minors included, expect some level of confidentiality when receiving health care services.

Providers and adolescent patients should discuss usual confidentiality practices, as well the types of information that providers are required to report. This will have an impact on a minor's willingness to seek health care services they may have otherwise avoided. Rules that providers or facilities may have about minor confidentiality and disclosure are not intended to prohibit or discourage minors from accessing needed health care services, but to encourage proper support in the decision-making process.

Oregon law does protect providers from civil liability when a diagnosis or treatment is provided to an authorized
minor without the consent of the parent or legal guardian of the minor. (ORS 109.685).

• For minors who self-consent for drug or alcohol treatment services in certain settings, providers are not permitted to disclose the minor's treatment records to the parent/guardian without written consent by the minor per federal regulation 42 CFR 2.14(b).
• All clinics and/or providers who participate in Title X grant programs must follow federal regulations regarding confidentiality per 42 CFR 59.11.