Monday, March 29, 2010

SB1309 (Parental Rights) has some LOUSY ideas in it... I wrote this to the House Health & Human Services committee. Given time constraints, this is hardly the tightest analysis I've ever given a thing, but I think I bring up some decent points.

Text of the bill is here; the Health & Human Services committee is here.

Dear House Health & Human Services Committee:

I write to you today in opposition to SB 1309, regarding adding a "Parents' Bill of Rights" to Arizona law, scheduled for vote on Wednesday, May 31.

The interests being served by this bill are supposed to be something like protecting parents' fundamental right to raise their children as they see fit. I agree; this is an important right. The rights of parents to determine the course of their children's upbringing are important. Parents are responsible for their children's health and welfare, and should therefore have a great deal of say in their children's lives. As a matter of policy, I have no particular issue with most of this bill, even the parts that annoy me (such as the requirement that parents opt into allowing their children to attend sex education classes rather than opt out of them). However, I do have an issue with the provisions that medical providers may not keep medical information about children confidential from the child's parents, and that do not allow children to receive non-emergency medical care without their parents' consent.

Parental rights are important, but minors have rights of their own. The right to one's own bodily integrity is perhaps one of the most important we have. Parents may have a fundamental right to have some say over their children's well-being, but children, like any humans, also have fundamental rights at stake here. I am not sure what purpose is served by refusing to allow children the benefits of confidentiality with their doctors. After all, for any procedure that requires consent, parents would have to be involved even without this measure: we do not consider minors capable of consenting to such things. All this measure does is prevent children from speaking candidly with their doctors, ultimately undermining their ability to receive health care. This goes directly against the driving force behind any parental-rights measure: that of helping parents raise their children to be healthy adults and good citizens.

We do not strip our children of their first amendment rights; why would we strip them of their rights to make decisions regarding their own health care? This is a particularly poignant question when we reach children who have reached certain milestones. We allow our 16-year-olds to marry (albeit with parental consent); we allow teenagers to petition for emancipation; we obviously trust that at some point, our children are capable of taking care of themselves. And yet, this bill says that, unless our children take drastic civil measures, they can have no say over what happens to their own bodies. At some point, parents' interests and children's interests start to diverge, and what the parent may want for his or her child, while not legally abusive, may still not be best for that individual human being.

For example, it is fairly obvious that this measure will make it very difficult for minors to obtain birth control pills without talking to their parents about it, which, in many cases, is not a feasible solution for the minors. (It makes other prescriptions difficult to get; however, I can think of no other situation where a minor would have similar difficulty talking to his or her parent about obtaining a prescription, except, perhaps, for treatment for STDs.) If the purpose is to prevent minors from engaging in sexual activity by requiring parents to consent to any medical care given, the statute is sadly misdirected. Minors who wish to engage in sexual activity but do not wish to inform their parents of the fact will simply obtain over-the-counter forms of birth control, or will simply do without. In the first instance, the purpose of the statute is not met; in the second, it is actually hindered because in addition to doing nothing to stop teens from having sex, it exposes them to disease and pregnancy.

This measure also disproportionately affects female minors because of its proscription against prescriptions being issued without parental consent. It does not forbid children from obtaining birth control. It forbids (or at least puts special hindrance on) female children from obtaining birth control.

This measure strips certain patients of their doctor/patient confidentiality. It will discourage candid communication between doctor and patient. Children who are engaged in harmful behaviors will be discouraged from discussing potential health problems with their doctors for fear that there will be repercussions at home, which leads to dangerous and potentially life-threatening situations.

Imagine being a teenager who acquired an STD. Say, further, it has not reached the point where it is a life-threatening situation - or, because your parents did not allow you to attend sex education, you don't know whether it is a life-threatening situation or not. If this bill were not passed, you could go to a doctor, tell the doctor what was happening, and receive treatment for your STD. Ideally, of course, you would be able to talk to your parents about this situation. But you're a teenager. In your eyes, parents are often totally unreasonable about this type of thing. And besides, if they know you had sex, you'll be in huge trouble. You don't want to talk to them about this problem. If you have the right of confidentiality with your doctor, there's no problem: you walk on down to your family doctor and get the problem taken care of. But if there is no such right, there is a much larger problem. You have to weigh your health against your parents' approval - or even, in some sad cases, their love. For a young person who has never had any major health issues, the choice could easily - and perfectly rationally - be to put off getting medical care until safely grown up and out of the house. Needless to say, this creates a huge health risk: minor health problems, ignored for years, can easily become major ones.

Furthermore, this measure allows parents to withhold medical care from their children completely, provided the situation is not life-threatening. Very serious illnesses will go untreated simply because, for instance, the parent believes the child deserves to suffer (most likely, for engaging in premarital sex or some such offense). It is difficult to imagine a parent who would do such a thing - but the horror stories are out there, and we cannot ignore them just because we have difficulty imagining such a parental mindset.

I am not saying children should be keeping secrets from their parents, or should be engaging in illicit sexual activities, or anything like that. I am saying that if we deny them the rights to doctor/patient confidentiality that we give to adults, health problems will develop. There is no purpose served that can justify stripping minors of their right to talk to a doctor in confidence. Please rethink the provisions in this measure, taking into account the interests of children as well as parents.

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