A member family from Oregon recently contacted us after their child, a minor, visited the doctor. While there, the child was asked to sign a document entitled “Limited Disclosure Authorization.” The document authorized the doctor to disclose a limited amount of the child’s medical information to the parents.
Of course, this document raised a question for the parents: If their child was being asked to sign an authorization for the doctor to disclose just a limited amount of information, was there more information that the doctor was not required to disclose to the parents at all?
Which raised a second question: Could a doctor legally see and treat their child without their consent and then never even tell them about it?
In Oregon, the answer to both of these questions is generally, “Yes.” When it comes to accessing medical records, Oregon state law is not very respectful of parental rights.
In at least some way, every state is subject to the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA).1 Among other things, HIPAA generally prohibits medical information from being disclosed without the patient’s consent. For the medical information of minors, however, HIPAA and its underlying regulations generally defer to state law.2
In Oregon, there is no law recognizing any right of parents to have access to their child’s health care information:
“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.”3
Moreover, there are several areas where Oregon law expressly provides that parents do not have a right to their children’s medical information, nor is parental consent required.
For a child to get hospital, medical, or surgical care related to the diagnosis or treatment of a venereal disease, including HIV, no parental consent is required, regardless of the child’s age.4
Although there is no law prohibiting providers from disclosing this information to parents, there is no law expressly permitting it either.5
A parent’s consent is not required for a physician or nurse practitioner to provide birth control information and services to a child, regardless of how young the child is.6
Oregon law does not define “birth control” in this instance. However, based on how the term is used in other Oregon statutes,7 the phrase would seem to include all forms of contraception, including “emergency contraception” (i.e. the morning-after pill, etc.), and may also include sterilization. Most significantly, the definition of “birth control” here is also understood by many to allow for a child of any age to obtain an abortion without parental notification or consent:8
Mental or Emotional Disorder; Chemical Dependency (i.e. alcoholism, drug abuse, etc.)
Children 14 years of age and older are not required to have parental consent to get outpatient care for a mental or emotional disorder.10
Without parental notice or consent, children 14 and older may also obtain outpatient diagnoses or treatment of a chemical dependency (i.e. alcoholism, drug abuse, etc.).11
In both instances, Oregon law does generally require the provider to involve the parents at some point before the end of treatment.12 However, in cases involving chemical dependency, this appears to conflict with federal law, which states that parents generally may not be notified unless the child consents to the disclosure.13
Hospital, Medical, Surgical, Dental, or Optometry Diagnosis or Treatment
Children 15 years of age and older can get almost any kind of medical care without parental consent, including:14
Children 15 and older can also get eye care from an optometrist without parental consent, except if the minor is obtaining contact lenses for the first time.15
For these areas, providers are allowed, but not required, to disclose this information to parents.16 As discussed above, however, the Oregon state government explicitly discourages disclosing information to parents about any reproductive health issues.
Finally, a minor 16 years of age or older may donate blood without parental consent or notice. 17
Clearly, the laws of Oregon are broad concerning when a minor can get medical care without parental consent or notification.
Thankfully, the parents that contacted us are not worried about their child seeking medical care without involving them.
Still, they were concerned that some of their child’s information would be withheld from them by their doctor since the document their child was asked to sign only provided for “limited” disclosure. While the parents were grateful that the doctor wanted to disclose at least some information to them, they wanted the doctor to be required to keep them informed about everything related to the health of their child.
To address that concern, we helped the parents and their child draft a document of their own which would provide the parents complete access to their child’s medical information with this doctor in the future.
After we had advised them of their rights and helped them prepare the new form, the family took the form to their doctor’s office and then offered to share the following about their experience:
“Heritage Defense exceeded our expectations in every way. Bradley Pierce not only did extensive research on Oregon’s medical disclosure laws with respect to minors, he then patiently explained them to us and offered us a course of action to protect ourselves and our children. We consider ourselves fairly well-informed parents, but we had no idea how badly Oregon’s medical laws had sought to separate children from the protection of their parents. The legal forms he created were readily (even gratefully) accepted by our doctor and may even be implemented as the new standard at our doctor’s office. Additionally, the report Mr. Pierce created on Oregon’s medical law concerning minors is an eye-opening document for Oregonians. Through it, I believe many parents and voters will become aware of Oregon’s situation and express a voice for change. We have yet to see the long-reaching blessings Heritage Defense is giving to Oregon families.”
Do you have these kinds of questions about your own parental rights? Would you like access to an attorney to get answers to these questions and others?
The parents in this article were members of Heritage Defense and had access to our attorneys to ask these kinds of questions about their parental rights. All they had to do was pick up the phone and call, or just send us an email.
If you would like to have the same access to our attorneys and more, please consider joining Heritage Defense today.
1 Typically pronounced “HIP-uh.” Pub.L. 104–191
2 45 CFR 164.502(a)(1)(i) and 164.502(g)
3 Minor Rights: Access and Consent to Health Care (Oregon Health Authority), Page 3 (last visited June 10, 2015) (emphasis original)
4 Or. Rev. Stat. § 109.610(1). Parents are not required to pay for these treatments for venereal diseases if a child gets the treatment without parental consent. Or. Rev. Stat. § 109.610(2). However, legislation which passed this week and is currently awaiting the governor’s signature would allow minors to have such procedures covered by their parent’s insurance without notice to the parent. H.B. 2758, 2015 Reg. Sess. (Or. 2015) (last visited June 11, 2015).
5 When disclosure to parents is neither prohibited nor expressly permitted by state law, federal law appears to give discretion to providers about whether or not to disclose:
“In cases in which State or other applicable law is silent concerning parental access to the minor’s protected health information, and a parent is not the personal representative of a minor child based on one of the exceptional circumstances described above, a covered entity has discretion to provide or deny a parent with access under 45 CFR 164.524 to the minor’s health information, if doing so is consistent with State or other applicable law, and provided the decision is made by a licensed health care professional in the exercise of professional judgment”
http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/personalreps.html (last visited June 10, 2015)
6 Or. Rev. Stat. § 109.640(1)
7 See Or. Rev. Stat. Ch. 435
8 Planned Parenthood: Parental Consent and Notification Laws (last visited June 10, 2015). Pro-life groups agree with this analysis of Oregon law:
“Oregon does not mandate informed consent or parental involvement before abortion…”
Americans United for Life: Oregon 2014 Report Card (last visited June 10, 2015)
9 Oregon Laws Regarding Family Planning, Page A4-2 (last visited June 10, 2015)
10 Or. Rev. Stat. § 109.675. For care provided for mental or emotional disorders or chemical dependency, parents are not required to pay for these services if a child gets them without parental consent. Or. Rev. Stat. § 109.690. However, legislation which passed this week and is currently awaiting the governor’s signature would allow minors to have such procedures covered by their parent’s insurance without notice to the parent. H.B. 2758, 2015 Reg. Sess. (Or. 2015) (last visited June 11, 2015).
11 Or. Rev. Stat. § 109.675. For care provided for mental or emotional disorders or chemical dependency, parents are not required to pay for these services if a child gets them without parental consent. Or. Rev. Stat. § 109.690. However, legislation which passed this week and is currently awaiting the governor’s signature would allow minors to have such procedures covered by their parent’s insurance without notice to the parent. H.B. 2758, 2015 Reg. Sess. (Or. 2015) (last visited June 11, 2015).
12 Or. Rev. Stat. § 109.675(2); see also Or. Rev. Stat. § 109.680
13 42 CFR 2.14
14 Or. Rev. Stat. § 109.640(2)
15 Or. Rev. Stat. § 109.640(2)(c). Your eyes do not deceive you. Yes, without parental consent, a minor can get an abortion but not her first set of contacts.
16 Or. Rev. Stat. § 109.650
17 Or. Rev. Stat. § 109.670