Teen medical ban heads to House floor

Posted May 7, 2013
Updated May 8, 2013

— North Carolina could be on the verge of implementing the nation's strictest law on medical care for teenagers. 

House Bill 693 would require notarized written approval from a parent before a doctor or other provider could diagnose, treat or even counsel anyone under 18 for mental health or substance abuse. Parental approval would also be required for contraception, pregnancy care and testing for sexually transmitted diseases.

North Carolina would be the only state in the nation to require parental consent for STD testing.

Sponsor Rep. Chris Whitmire, R-Transylvania, says the bill "strengthens parental rights in their determination of what's appropriate in terms of their child's medical needs."

Whitmire said that, if a minor needs mental health, substance abuse, STD or contraceptive care, "it reflects a risky behavior that goes down a primrose path that yields these outcomes. It's very behavioral related." 

"We make (teens) wait till they're 18 to buy cigarettes, 21 to buy alcohol," Whitmire told the committee. "With the particular items that are very serious, that threaten their health, they certainly need a parental figure."

Doctors spoke out against the proposal. Groups opposed include the North Carolina Pediatric Society, the North Carolina Medical Society, the North Carolina Academy of Family Practice, the North Carolina Child and Adolescent Psychiatry Association, school nurses and public health directors. 

Dr. John Rusher, speaking for the pediatricians, said the proposal would discourage teens from seeking medical or psychological help that could save their lives. 

"You're going to eliminate a certain subsection of patients with either substance abuse or who have been subject to child abuse, physical abuse or even emotional disturbance that are not going to be able to come seek care because they can't do it in confidence,” he warned the committee.

"I have had numerous instances where teenagers have come to me in confidence to discuss concerns they have about fears of pregnancy, sexually transmitted infection, HIV," said community physician Dr. Neva Bartholomew. "I’ve been able to counsel them because I’m able to assure them that they have my confidentiality.

"If they think that we are going to tell their parents about everything they come to talk to us about, they are not going to tell us what is going on, and they are not going to come in," she said. 

But Tami Fitzgerald with the N.C. Values Coalition called the bill "a commonsense bill that puts control back in the hands of the parents, where it belongs."

"There is something insanely wrong about physicians' associations coming into this building and asserting that their judgment should be substituted for the judgment of a child’s parents," Fitzgerald told the committee.  

Jere Royall with the North Carolina Family Policy Council also spoke in support: "Sexually transmitted diseases, abuse of controlled substances or alcohol, mental illness or pregnancy are critical, sensitive and necessary areas for parents to be aware of and involved in."

Rep. Marilyn Avila, R-Wake, said allowing teens to receive confidential medical care or advice is "an insidious sort of thing."

"We're undermining our families by creating this 'Don't tell mom and dad, just come tell me,'" she said. "If you look at the direction our children have taken in the last 20 or 30 years, maybe we've created some of the problems." 

But Rep. Beverly Earle, D-Mecklenburg, called that outlook unrealistic.

"There's a whole world of other young people out there that don't have that relationship with their parents. Many of the parents are not there. Some of these kids are being abused. There's this word of different issues out there," Earle said.

Rob Thompson with Covenant with North Carolina Children agreed minors who are physically, emotionally or sexually abused by their parents or guardians would be especially vulnerable.

“None of these youth should be required to go back to their parents and ask them to consent for them to get medical care for those instances,” he told the committee.

The bill would also extend to pharmacists, who would be unable to dispense any medication used to treat any of the subject conditions without the presence or notarized permission of the parent.

However, because federal law requires strict confidentiality in the provision of medical care and bans age discrimination against minors, providers who get Title X or Medicaid funds would not be subject to the parental consent requirement. That would include most community health centers, county health departments and Planned Parenthood.

House Bill 693 also adds a new restriction on abortion. It would require written, notarized parental permission for a minor seeking an abortion, even if the parent is present with the teen. Critics say the purpose is to shame the parent by having to reveal the abortion to a notary – a third person who has no duty to protect medical privacy. Whitmire didn't explain why notarization would be required if a parent is present. 

The measure passed the committee largely on party lines, 14-8. Its next destination is the House floor, where it could be heard Wednesday. 


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  • wingman1963 May 10, 2013

    Just want to thank Rep Whitmire and Tami FitzGerald for their leadership on these issues. Clearly, in order to preserve out freedoms we need Retrogressive, social conservatives vetting each and every of our healthcare decsions, and especially when such oversight is contrary to common sense and sound medical practice.

    I look forward to the day when the Retrogressives in the State House set up local panels to whom we can turn for approval on other personal choices, such as what to have for dinner, what clothes to wear and whether any given hairstyle would be a gateway to a "primrose path" leading to social chaos.

    Thank you Rep Whitmire, Thank you Mrs FitzGerald- Back to the 1950s!

  • madeuce2010 May 9, 2013

    Why is mental health included in this? Why is verbal parental consent no longer good enough? Some notary publics charge a fee of maybe $5, so if you're poor and your child gets weekly treatment for ADHD, if you don't have $5 to spare that week is your child supposed to forgo their treatment??

  • Smoras_of_Borg May 9, 2013

    "Whitmire said that, if a minor needs mental health, substance abuse, STD or contraceptive care, "it reflects a risky behavior that goes down a primrose path that yields these outcomes. It's very behavioral related."

    So, technically, if a teen seeks counseling from a pastor/priest, the teen needs parental consent AND a third party notary before doing so.

    So much for 'freedom of religion', eh?

  • swedenag May 8, 2013

    Right now, at least in Wake County and possibly statewide, when adolescents go to a pediatrician for a routine checkup, there's a confidential survey they fill out, including questions about drug use, sexual activity, home life, etc. They also ask, at the beginning, whether the teen would prefer their parent inside or outside the room. Never have I heard this questioned, because everybody knows that a teenager isn't going to tell their parents everything. They're scared of disappointing somebody. Being able to go straight to somebody who is interested in their well-being without the perceived judgment that teens feel from their parents is a gift to these kids. Plus, if there's a problem at home and a kid goes to a doctor to get counseling/treatment, and something's wrong, then the kid is treated and the incident is reported to authorities. What's wrong with the way things are now?

  • tayled May 8, 2013

    I just hope that McCrory doesn't fall victim to this incredible monstrosity that the Republican Legislature is becoming.

    He already has. He is a mere puppet for the GOP and Art Pope. If he had any backbone at all, he could put a stop to some of this insanity.

  • Black HelicoptersNFood Insurance May 8, 2013

    Is this less laws, more personal freedom, job creation, or less burden on business? Cause it looks like the polar opposite of everything the GOP *claims* to stand for.

  • bricemsayssam May 8, 2013

    Why do Republicans think it Takes a Village To Raise a Child ... as long as THEY'RE the village?

  • jjsmith1973 May 8, 2013

    Well so much for me taking my sister kids for a couple weeks during the summer. I would hate for something happen, like them getting sick or slipping and breaking something. Then me not being able to get them treatment because I'm not the parent. So now NC is going to make it so I feel like I can't properly have family visit like my nephew without my sister or brother in law being here for fear I wouldn't be able to ensure their safety because of this law.

  • SaltlifeLady May 8, 2013

    If this bill passes and becomes law it will have profound negative consequences. It would be a huge step back for the goals of Healthy People 2020. In a state where its fact teens are having sex and don't always talk to their parents, and have access to pregnancy and STD prevention, testing, and treatment without parental consent the rates are still alarming. These rates will only go up if parental approval is required. In 2011 in ages 15-19 there were 97 cases of syphilis, 4553 cases of gonnorhea, 18,444 cases of chlamydia, and 93 cases of HIV. These numbers will only go up in the 20-24 age group because the teens who will have contracted these will only continue to spread them longer before its detected and treated. There were also 13,909 pregnancies in women under age 20, 26% of which were repeat pregnancies. There needs to be more comprehensive sex ed in the schools and access to services. Mandating parental involvement isn't the answer. Signed-- a mom and school nurse.

  • prodigalrn May 8, 2013

    The reason Republicans are doing all this wild stuff in the legislature (gay marriage, guns, fracking, youth healthcare limiting) is that they can't focus on the JOBS, JOBS, JOBS they campaigned on, because their policies will do nothing to foster more employment, only to provide more income to the upper portion of our citizenry, while curtailing all the safety-net programs we had in place for the poor. All you will see from the Republicans are more bizzare bills like this one, and many more, because that's all they have, and they're pandering to their farthest-right, craziest base of the party. I just hope that McCrory doesn't fall victim to this incredible monstrosity that the Republican Legislature is becoming. I'm tired of comedy shows making fun of the latest NC voyage back to the sixties. Enough already. Get back to the Jobs, Jobs, Jobs you campaigned so hard for.