Sharon Sullivan, RN | August 29, 2024 | SHARE: 
Did you know that there is a decades old state statute in North Carolina that allows children to consent to some serious medical treatments without their parent’s knowledge?
Currently, minors in NC can seek and consent “for medical health services for the prevention, diagnosis and treatment of (i) venereal disease and other diseases reportable under G.S. 130A-135, (ii) pregnancy, (iii) abuse of controlled substances or alcohol, and (iv) emotional disturbance.” It’s hard to imagine many more serious health issues for a minor to contend with, and, certainly, most parents would want to have the ability to counsel their children on these important topics. And, if you are wondering if 2023’s Senate Bill 49—Parent’s Bill of Rights (PBR) closed this gaping loophole in minor consent laws, you’ll likely be disappointed by the answer. All of this is permissible, without parental consent, under N.C. General Statute 90-21.5.
In 2023, the General Assembly passed Senate Bill 49—Parent’s Bill of Rights. The new statute clarifies and codifies many rights of parents when it comes to their child’s education and health care. For conservatives in North Carolina, the passage of the Parent’s Bill of Rights was a big win, particularly because it recognizes the important role of parental involvement in many areas of education and health- including the current critical issues of children’s gender confusion and sexuality. But in the months after the law passed, it became clear that a North Carolina statute from the 1970s could still prevent parents from knowing some of the most important medical issues concerning their children. Unfortunately, the Parent’s Bill of Rights (PBR) has had no impact on this long-standing law, because the PBR includes language recognizing existing exceptions to parental consent requirements.
Passage of the Parent’s Bill of Rights was a big challenge for the legislature, and ultimately required an override of Governor Roy Cooper’s veto. After the PBR’s passage, many parents around the state breathed a sigh of relief, until several news stories revealed limitations regarding parent’s rights to their children’s health information. News outlets reported that Atrium Health was blocking some minor children’s prescription records from their parents. Atrium partially revised this decision after parental pushback. In another story, a mother whose 12 year old daughter appeared to be under the influence of a substance when she was picked up from school was denied a drug test at Novant Health when the minor child withheld her consent for the test. These stories raised statewide questions about what rights parents actually have when it comes to their children’s health. Some of the answers are very troubling.
In 1971, the NC General Assembly passed a law that allowed minors to seek and consent to diagnosis and treatment of venereal disease and other reportable diseases. It was amended in 1977 to include the prevention of such diseases. In that same year, pregnancy, abuse of controlled substances or alcohol, and emotional disturbance were added to the list of health services minors could consent to on their own. These carveouts have remained in our state laws ever since. It is important to note that this statute does not apply to abortions for minors which, fortunately, still require parental or guardian consent in almost all circumstances in North Carolina.
If you’re asking why these laws exist, you’re not alone. These statutes were presumably written to encourage minors to seek the health care they need, or want, but might be afraid to pursue because of the potential of their parent’s extreme reaction, possibly including abuse. However, recalling the 1970’s, it’s clear to see that our culture and society were vastly different then. A nuclear, church-attending family was the norm in the 1970’s. Children then were not constantly being encouraged to withhold secrets from their parents, or to abandon the views and the principles that their parents impressed upon them. Overall, parents of that time were regarded by most as their child’s rightful authority. Today, parents fight a daily battle for the hearts and minds of their children that we didn’t anticipate in the 1970s.
Arguably, North Carolina’s minor consent laws are a prime example of the old adage “Hard cases make bad law.” There are, of course, some hard cases where parents wrongly fly into a rage and harm their child when they discover that their child was in need of certain medical treatments; but this certainly would be rare. Most parents desire to see their children succeed in life spiritually, mentally, and physically. The presumption that parents will overreact and harm their child is a flaw in the law, particularly in our current culture.
The assault on parental rights is clear here, but also let’s not forget about children’s rights. As Katy Faust, author, public speaker and the Founder and President of Them Before Us has persuasively stated, children have a right to their mom and dad. When considering the issue of minor consent, some NC laws deprive children of the loving careful consideration and advice that a parent would give. Generally speaking, no one will have more of an interest in the wellbeing of a child than their parent. If a child does not receive this type of care from a parent or guardian, it is the exception, not the rule. Nevertheless, NC has other laws that are designed to protect children from abuse and neglect.
Keeping parents in the dark about serious health issues also breaks the very important parent-child relationship bond. Importantly, studies suggest that positive parent-adolescent relationships can lead to improved general, mental, and sexual health outcomes in children, and may even reduce substance abuse in young adults. Therefore, our minor consent laws may actually be undermining these relationships and putting our kids at greater risk for future harm!
There are also ethical questions surrounding minor consent. A basic tenant of medical practice is obtaining informed consent. Children, because of immaturity, inexperience, and lack of critical thinking ability cannot truly give informed consent. The American Medical Association (AMA) states that, “Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.” The AMA instructs physicians to, “Assess the patient’s ability to understand relevant medical information and the implications of treatment alternatives and to make an independent, voluntary decision.” Informed consent can be difficult for adults to consider, so how can we expect this from our children? Are we really considering the child’s wellbeing in our society if we are willing to secretively treat a child for important, and potentially dangerous health concerns?
Under our minor consent laws, children can seek treatment for “emotional disturbance.” This is very broad terminology and open to subjective interpretation. Some psychiatric medications can exacerbate a patient’s symptoms before they begin to help, leaving a vulnerable child at greater risk for harm. Meanwhile, this may mean that a parent may have no idea that their child is experiencing an emotional disturbance, or taking a psychiatric drug.
The laws also allow for children to seek care for the prevention of reportable communicable diseases. NC’s list of reportable communicable diseases includes numerous diseases for which many children are immunized. Under the law, a child could receive a vaccine that the child’s parent thoughtfully decided not to have administered to them, all without the parent’s consent. A good example of this is the HPV vaccine which is given to prevent the sexually transmitted infections and the cancers related to the infections. The vaccine has been on the market for several decades, but is not as common as those given in early childhood such as the MMR or T-Dap vaccines. A debate is on-going as to the HPV vaccine’s safety. It is a vaccine that should be seriously and thoroughly considered before it is administered.
These are just two examples of the perils associated with NC’s minor consent laws. The issues of addiction and pregnancy come with their own sets of risks. It doesn’t take much thought to realize how these laws endanger our children and jeopardize the parent-child bond, ultimately damaging the family unit.
Parents have a fundamental right “to make decisions concerning the care, custody, and control of their children.” Parental authority should not be usurped when a minor child seeks certain medical care, particularly for the significant health issues that are carved out in our minor consent laws. The issues of sexual and mental health, and the use of alcohol and other substances are some of the most important issues a parent will ever discuss with their children. Few parents will want to leave these crucial discussions to a person outside of the parent-child relationship. No one will love and care for a child the way a parent does. As such, the state should return these powers back to the parents, effectively giving parents back their rights—finally after more than 50 years.
