Wednesday, March 24, 2010

Who is Responsible for What?

I really am not sure who's side I am on here. There are a lot of nuances here (meaning a big can of worms). When do parental rights stop and at what age? I am VERY interested to read what this group thinks of this.

http://www.seattlepi.com/local/417276_abortion23.html

32 comments:

zb said...

I think the consent forms should be more explicit about what you're consenting to. But, I think that the medical privacy of 15 year olds should be respected, once that consent is obtained.

The problem I see here is that the mom signed the consent form without understanding that it guaranteed her daughter medical privacy. I wouldn't sign that kind of document for my nine year old. I might consider signing it for a 15 yo, but I won't know until I have one.

I'm pretty supportive of children's right to privacy as they mature. The other day, I stopped by at the library, and tried to get my daughter's pin number. The librarian, bless her heart, was worried. When I told her my child was nine, she was willing to give it to me, but asked if I could bring my daughter in instead. I decided I'd rather support my daughter's privacy by bringing her in to get her own pin. Of course, then, had to write it down, since she can't yet keep track of it. But, I liked that the library was protecting her privacy about her reading. I consented to that privacy when she got her library card.

On the other hand, she's not mature enough to make her own medical decisions, and I wouldn't consent to that yet.

Laura said...

I'm all for the teen health center. A world without the teen health center is a world I don't want to live in.

That said, I find it disturbing that the child was told as long as she kept if secret from her parents she could get a free abortion. I'm not so sure that's exactly what happened. Anyone know the policy? Free if you keep it a secret, parents pay if they know about it?

Amy Lang is a local sex educator. She has lots of ideas about talking to your children about sex, birth control and abortion. My kids are only 4 and 9, but she's gotten me started. I want my kids to come to me with these questions, but if they don't feel like they can, I'm glad something else is in place.


FYI: Amy's web site is: http://birdsandbeesandkids.com/ and she gives many talks in the area.

Hippy Goodwife said...

I think the story is poorly written and lacks details. It sounds fishy. Why was the phrase "pro-life advocate" used in reference to a young woman who has just had an abortion. Are we to infer that she was tricked? forced? Why the keep it secret and it's free clause.
I think that 15 year olds have a right to medical privacy. I think that the parent did not adequately understand the consent form, is angry at herself and disapointed/angry with her child. But is is much easier to her mad at the big bad school clinic instead.
I am glad this young woman had someone to turn to since it appears that her parents might have been less than supportive.

RavennaJen said...

That 15-year-old obviously didn't feel comfortable discussing the issue with her parents. The mother described her daughter as "a pro-life advocate." My guess is this poor girl didn't share those views with her mother and was too afraid to tell her mom lest she be convinced to not abort. As much as I would want my daughters to feel comfortable to discuss issues like this with me, I also want for them to make decisions about their own bodies with competent medical advice.

Sully said...

I am on the fence about this one.

I definately think teens have a right to privacy. Sometimes, kids just can't go to their parents, especially for things like contraception, and I like that these kids have other options in the teen health center, planned parenthood, etc.

But I think a parent has rights too. The consent form should be absolutely clear as to what you are consenting to.

I signed the consent form for my son without a second thought. I didn't even think about the scope of authority I was transferring over to the teen health center because when I think of the center, I think about sports physicals, immunizations, doling out aspirin and tylenol, vision and hearing screening, std screening, and counceling about/administering contraception.

I don't think of the teen health center as a place that facilitates any major medical procedure, including abortions.

What, if any, are the teen health centers limitations? Can they schedule your teen for breast implants or a nose job? Can they send them to a psychologist and get them diagnosed with ADD, and a perscription for Ritalin? If so, is that OK? Not for me.

If it's not OK, then why not? If they can schedule an abortion, why not a breast augmentation or an ADD diagnosis?

I think I'm going into the teen health center today to get a copy of my consent form....

Shannon said...

Its sometimes hard as children take control of their medical decisions. As a parent I would hope that my child would turn to me to help them through something like this. To work out what they want. It is heartbreaking to think of anyone that age being put in a taxi and sent off for a medical procedure (surely frightening and a bit emotional) without support.

BUT

Its her choice.

I think if you make it about something less controversial than abortion, you can see the issue is about parents role at the cusp of adulthood.

My younger child has a serious CHD. Friends whose teenagers have CHDs which need lifelong treatment and face life threatening complications if medications aren't taken, have awful anxiety as the child transitions to seeing doctors alone. Doctors encourage this process and for the teens to take over but still... that there is a role for you as a parent seems pretty self evident?

hschinske said...

I live in Ballard and have two fifteen-year-old daughters; it's entirely possible that I know this girl or her mother (though I have no guess at who they might be), so this strikes home for me.

Naturally I would rather my daughters talked to me or their father if they got pregnant or had any other serious health concern, but the reality is that they might not, and their safety is more important than our being consulted.

I don't suppose anyone is arguing that the parents of the boy involved (I hope it was a boy more or less her age, as otherwise we're talking statutory rape) should have been notified, though genetically it's all the same.

Helen Schinske

Melissa Westbrook said...

Ditto on ZB's first paragraph. I would want to know, very clearly, what the ramifications of my signature were. I wouldn't have thought this would include abortion either.

That said, signing the document allows teens who might not get health care and health care advice the assurance that they can say anything to the health care provider in privacy (save if the teen is thinking of hurting herself or others).

I'm thinking the girl told her mom after the fact because she really wanted to before the fact but couldn't. It's sad that she feared her mother's reaction.

Michael is right; this is very difficult because we all have our own opinions on the subject of abortion.

emeraldkity said...

Regarding pregnancy care for minors- if someone is old enough to get pregnant- they are old enough to tell their parents .

I can empathize with parents who do not have a relationship where that would be possible- however THAT, is the problem, not that the child is receiving medical care without her parent's knowledge.

The pregnancy may be a case of incest or abuse, in which case informing the parents may put her in danger.

In my experience ( my school didn't have a teen health center- but during high school & afterward for a few years, I used Planned Parenthood as my main source of health care- not just birth control), the clinicians do a good job of informing patients of all their options and will talk to parents if needed.

Again- if the parent-child relationship, is not all it could be, blaming the school is looking in the wrong place.

Dorothy said...

Good comments here. Thoughtful. Especially the comment that the mom is angry and disappointed at herself and her daughter and taking it out on the clinic.

The reality is though, that teens do have rights to privacy, more than we sometimes think. The teen center did not perform surgery. All we know is that the teen health center helped her find a place qualified to perform the surgery.

A minor can get an abortion in Washington without parental consent. So what's the deal here? She could have not used the teen center at all and gone straight to planned parenthood without her mom ever signing a consent form. But would she have known that? Would she have had access to information and counseling without the teen health center on campus? Let's hear it for the health center for helping kids stay safe.

A friend with a child who sees a psychiatrist told me that this teen's rights vs parent rights is wider than this health center thing. Her son's doctor cannot discuss things with her without the teen's consent (except of course if there's suspicion of danger) not even when the doctor and teen are discussing medication and selecting medications. She will not know what medications her son is taking (or not taking) unless her son chooses to tell her. Did she sign a consent form in the first place? I don't know. But if signing such a consent form is standard practice, would you not sign and not get our child treated?

(And I am surprised the library gave out the 9 year old's PIN, since I thought they made it very clear that they protected the privacy of all card holders. I have overheard librarians refusing to give parents information about their child's account. And when my then 15 year old started at UW last Fall we found out that college students have total right to privacy on grades. Even though we pay tuition, we have no way to access his grades without him showing them to us. And nothing comes in the mail for us to steal, even.)

The moral here (if there is one) is to do everything you can from an early age to foster a healthy and honest relationship with your child.

zb said...

"I'm not so sure that's exactly what happened. Anyone know the policy? Free if you keep it a secret, parents pay if they know about it?"

I can vaguely imagine that a policy could have that unintended consequence. I.e. it's possible that if a parent isn't involved, the clinic treats the child as being uninsured (and independent), but once a parent is involved, the child is now part of the parent's health insurance policy, with the rules dictated by it.

If so, that's an issue that the clinic should be reviewing. I can imagine that a 15 year old child might hear that information, and think that they're doing their family a favor by getting something for free.

And, that misunderstanding could occur without the person giving the information understanding what's happening.

Dealing with 15 year old minds in women's bodies is a challenge for everyone (including the 15 year old).

emeraldkity said...

I am surprised that FERPA allows minor college students to act as adults- but that also reminds me that even when you are being billed & even though FAFSA considers children to be dependent until they are 24, parents aren't notified of grades or health issues, unless the student signs a release form.

Also although this is off topic- regarding tuition- my husband and I took a PLUS loan to pay our daughters tuition, but since it didn't look like it was going to be processed in time, we paid it another way- when it did get processed, the refund was given directly to our daughter at school.

So good to work on those relationships with your teens now, save money later!

zb said...

"And I am surprised the library gave out the 9 year old's PIN, since I thought they made it very clear that they protected the privacy of all card holders."

Oh, she didn't. It did seem like she was considering letting me have it, perhaps if I said how hard it would be to bring my daughter in. But, we never got to that point, so library policy was certainly not violated. And, it's certainly possible that I misinterpreted her willingness (and, my daughter was probably 8, not yet 9 when this happen).

ParentofThree said...

I agree with HippyHousewife the story is a tad fishy and I do not believe all the facts are being reported.

This quote from the mom popped out at me:

"They just told her that if she concealed it from her family, that it would be free of charge and no financial responsibility."


I don't believe that the teen was told this. As far as the law goes, women in this state have the legal right to an abortion and the mother does not have any rights over her daughters body as she seems to think by saying:

"Makes me feel like my rights were completely stripped away."

I would also like to see that waiver as I would think it makes it very clear that the clinic is not run by the school. If it doesn't, it should!

Moose said...

Very thought provoking. I am impressed with the thoughtful commentary on this subject here (in contrast to the bulk of the comments on the PI).

I don't have kids in high school yet, so I may be totally naive, but is no one else sad that a 15 year old is having sex? This kid (clearly!), and most 15 year olds are not emotionally, financially or psychologically ready for the consquences of sex. She had the opportunity to get birth control from this very clinic -- and obviously did not use it (or did not use it properly). Sad, sad, sad.

agibean said...

As I understand it, an abortion is free if you "don't tell" because there is a fund that covers it as if you had no insurance through your parents. Obviously, telling your parents would bring in their insurance, so it's not free.

I HAVE a daughter who was a teenager just two years ago, who went to school with girls who did get pregnant while in high school and who went to the school clinic as a first step. Believe me, there are many girls who can't talk to their parents about any aspect of sex, let alone birth control or abortion. These clinics are godsends for them.

At my daughter's school, the permission form had different levels of what you could allow the clinic to do for your child. One option was no access at all, one was pretty much total access, which is what I signed for.

Because I watched girls' lives get ruined in high school through teen pregnancy, I always told my kids they were more than welcome to come to me for ANY advice, but if they felt more comfortable going to the school clinic, then by all means, do that rather than nothing or trying to go it alone.

I think the mother in this story and her views are precisely why the girl did what she did the WAY she did, and it's unfortunate that her mother has gone public. She's using her daughter to teach a lesson SHE believes in, after signing a form without reading it carefully. That's a shame.

emeraldkity said...

I did find that the staff at the high school health center to be very helpful. ( @ Garfield, it is operated by the Odessa Brown clinic)

I had some concerns about my daughter- she had some health issues and she also was inclined to withhold info from me and other adults.

( for example- we would go into the Dr, after she had been complaining of earache/stomach ache etc., but then she would say " I feel fine- nothing bothers me" - kind of like those cars that stop making the noise as soon as you take it in)

So I made an appt to see the nurse practitioner to talk knowing that she wouldn't be able to tell me about D, but I was reassured knowing that she had a fuller picture of her.

( I also knew her from another health organization and had the highest opinion of her judgement & skills)

So while you can't be directly informed re: medical issues without your childs consent after ( 14?) , you can develop a relationship with your childrens care providers, just as you can with their teachers.

emeraldkity said...

This kid (clearly!), and most 15 year olds are not emotionally, financially or psychologically ready for the consquences of sex. She had the opportunity to get birth control from this very clinic -- and obviously did not use it (or did not use it properly). Sad, sad, sad

Well- the sex drive is very strong in most people, and certainly in teens. I don't think that adolescence is a great time to start a sexual relationship- but without knowing more about it- I couldn't pass judgement, birth control does fail, but it is possible that someone who was raised to believe that all sexual activity without marriage is wrong, they may not be using birth control appropriately ( or at all).

All the more reason to have appropriate and accurate information in the schools.

Talking about sex, just as talking about other difficult subjects ( like suicide) does not introduce the idea- teens are already thinking about it- but when you have to get info from other sources, it may not be helpful and may be even harmful.

Maureen said...

I agree with zb
The problem I see here is that the mom signed the consent form without understanding that it guaranteed her daughter medical privacy.

If you look at the actual Consent Form she must have signed, it says right up front:

Consent is also given for referral of care and if needed, emergency transportation, to other physicians, health care professionals, hospitals, clinics, or health care agencies as deemed necessary by the Center and its staff.

The words reproductive health care are used throughout (not birth control).

I signed a similar form for my now 15 year old (son) and am not surprised that the consent would include a referral for an abortion. I feel sad for the family that they could not communicate when it mattered and that the mother feels the need to blame someone else for what happened.

Stu said...

I find it disturbing that the child was told as long as she kept if secret from her parents she could get a free abortion.

This is a really strange story . . . I'm pretty sure that we're missing some details.

The mother signed a consent form; the girl had sex; the girl went to the health clinic; the girl had an abortion; the clinic kept her confidence; the girl CHOSE not to tell her mom until when?

Without every side of the story, it's hard for me to believe that the clinic told her that it would be free if she kept it a secret from her family. No professional would say that to a 15-year-old . . . there's something missing here. That they "put her in a cab?" Doesn't seem right either.

Did she decide to do this during school hours when her parents weren't around? Probably. Did someone, perhaps, help her call a cab? Probably. Did she get the advice she needed at the clinic . . . only she knows for sure but she went in there and, supposedly, made a decision.

It would be interesting to know all the details but I'm sincerely hoping that the family decides to keep this private matter private. The mom's pissed about this and is taking it out on her daughter and school district . . . but even based on the spotty information we have, this has nothing to do with the district; it's between the family and the clinic.

stu

Stu said...

agibean wrote:

As I understand it, an abortion is free if you "don't tell" because there is a fund that covers it as if you had no insurance through your parents. Obviously, telling your parents would bring in their insurance, so it's not free.

Oh . . that actually makes sense.

stu

jean said...

I too think the story was poorly written, but I find that the norm with both the Times and the PI, just not much info. Lots of inflamatory statements with missing facts.

The Ballard Teen Health Center clearly states on the homepage that "Emergency Contraception" is offered. Emergency contraception means some sort of morning after pills (pregnancy termination or peace of mind after a bad decision.)

http://www.ballardbeavers.org/Services/Student%20Health/bthc.html

I'm so sorry the mother didn't understand the rules. Ideally she would have been in the decision making process with her daughter. But I am thankful the daughter was able to get healthcare.

Melissa Westbrook said...

This story was written by KOMO-TV staff so sorry, but tv people don't seem to have the journalistic standards that newspaper folk have. They don't always get that details count.

That said, here's the thing about the PI. They don't have regular professional journalists covering every story. I had to get a retraction at their website for printing a story that included me and had two wrong statements including one they attributed to me that they made up from the voters pamphlet (and I never talked to them). That was a UW student in the journalism school.

I miss the old "real" PI.

Chris said...

That "free if you don't tell" business is third-hand, and this mother's credibility is a little squishy anyway IMHO ("my daughter is a pro-life advodate.") I wouldn't get too excited about it except perhaps as irresponsible, sensationalist reporting.

This was an excellent story for me to hear, though, as the parent of a tween. Sometime between elementary and high school you go from being a "driver" to a "passenger" in the car of your child's life...The extent that you control your child's actions decreases and the best you can expect is to participate, and that's by invitation only. I need to behave now in such a way that I keep getting invited.

Lori said...

Emergency contraception (EC) is not considered by medical professionals to be an abortifacient. And it doesn't sound from this story that this teen got EC, which is taken within 48-72 hours of unprotected sex or contraceptive failure to prevent conception and/or implantation.

I saw posts on the PI site and here that suggest that she had a surgical abortion. However, the article is unclear. She may have had a medical abortion with RU-486, which can be used very early in the course of pregnancy with high success rates. It is not invasive; it is not a surgical procedure. It's a couple of pills, usually taken by mouth a few hours apart. The actual termination of the pregnancy occurs in the privacy of your own home.

I'm a pharmacist in real life, and knowing the safety and efficacy of the regimen, I'd feel very comfortable with a health clinic counseling and dispensing RU-486 for a teen to use on her own. That said, I still think it's incredibly sad that this teen didn't feel like she could talk to her family and that she underwent whichever procedure on her own.

agibean said...

Chris,

It's not third hand. I asked a LOT of questions before I signed the papers when my daughter was a freshman.

Think about it-if you are going to use your parents insurance, by default, they will find out what you are using it for. At the very least they would see insurance statements coming to their child that they would want to ask questions about.

So, because by law minors are allowed to get abortions, there has to be a way that they can safely do so at no cost to them, or else they would need to go to their parents, which would defeat the entire putpose of the law-being able to get an abortion WITHOUT the parents being involved.

The fact is that there are a LOT of kids who would be in danger of mental or physical abuse if they got pregnant, not to mention victims of incest, etc. who simply cannot have their parents know. Thus, this law.

I'm guessing in this case, the girl didn't want to tell her mother, but either wasn't feeling well, left a paper laying around with instructions or a prescription on it that mom found or something like that, leading to questions, which lead to her telling her mother the whole story.

Give mom's public reaction, I'm guessing the girl had a good reason to leave her out of her initial decision.

SolvayGirl1972 said...

Since my daughter was 14 (I think) I have had to sign a form stating that I understood that her medical records could be kept confidential from me—including any discussion of birth control, etc. This was true with her pediatrician at Virginia Mason, her naturopath and a counselor. At every visit I get kicked out of the room so they can talk with her in private. It is her choice to discuss whatever they talk about with me; so far she does.

As for a physician prescribing drugs without my consent. They probably can, but then whose going to pay for them? (I'm talking about ADD meds, birth control, etc.) I guess if a teen has the means to pay for their own pharmaceuticals they can.

As all have noted, as parents of teens, it is our job to guide them to a place where they can make good decisions ultimately without input from us (that's what being an adult is all about). But even adults need someone to bounce their options off, and it's nice if that person is someone who truly cares about them. So, we should all work to create a relationship where our child feels safe telling us the worst.

Chris said...

The mom saying the daughter saying "they told her" (it was free if the parent's didn't know) makes it third hand. You make the point that someone probably did say something like that, given your additional knowledge. Still sucky journalism.

wseadawg said...

Shouldn't this be resolved by the family, around their kitchen table, and not plastered throughout the blogosphere and on the news? I can't believe they went to the press with this. So much for respecting the girl's desired privacy.

Stu said...

So much for respecting the girl's desired privacy.

Which give us a little insight into why she didn't go to mom in the first place. As if this wasn't hard enough on her she now gets to be paraded around . . . lovely.

stu

Robin said...
This comment has been removed by the author.
Robin said...

I had an abortion as a teen. It was a very difficult and exremely emotional decision for me. I had a very accepting and supportive family that would have held my hand and supported me through everything, no matter my decision. But I was 17, confused, and very embarrassed - I chose not to tell anyone except my boyfriend.

I understand the need for privacy first hand and thank god for planned parenthood and sliding scale clinics.

As a parent now, I totally respect my kids right to privacy. I hope they are never in this circumstance but if they are I hope they can come to me, however if they choose not to, I totally understand....