Child/Teen Health Rights in Oregon: What You Should Know

In family practice, we are frequently placed in delicate situations caring for minors, with regards to parent involvement and patient confidentiality and rights.

It is helpful for parents, caregivers, adolescents, teens, and all health care professionals to have a basic understanding of the legal rights and protections of minors in Oregon.

You might be surprised to learn, for example, that in Oregon, a patient can start a medication for depression or anxiety as young as age 14 without parental consent, get medical care such as a vaccine or physical exam at age 15 without parental consent, and get birth control at any age without parental consent.

Don't shoot the messenger-the author did not make these laws--but healthcare professionals do have to abide by them.

It is especially helpful for those in mental health and who work in academics to be aware of these laws when advising youth and parents of minor's rights.

Some examples of difficult minor's health issues that we've encountered in family practice include the following:

-- a young teen wanting to start antidepressants but the parent refusing

-- an young adolescent wanting birth control but too afraid to tell their parents

--a teen wanting to get the HPV vaccine to protect himself and future partners against HPV-related cancers but his parent refusing

-- a 14 year old being seen for “stomach cramps” who ends up being pregnant but doesn’t want parents to know

--an adolescent positive for chlamydia who wants treatment but doesn’t want caregiver/parent to know

--a 15 yr old assigned male gender at birth who identifies as female and wants to start testosterone-blocking medications and estrogen

--an alcoholic 16 yr old who wants treatment but doesn’t want dad to find out and can’t afford treatment

--a teen whose parent is demanding we start teen on mood stabilizer or parent will stop paying for their rent and education.

Balancing the rights of parents and the rights of minors remains an area of controversy.

There is an acknowledgement on the part of lawmakers that while parental involvement is desirable, many minors will not seek services if they have to inform their parents.

Most youth-serving agencies and medical professionals believe that access to confidential services is essential because many sexually active adolescents or adolescents involved in substance abuse will not seek care if they have to inform a parent or have their parent's consent. Minors' consent laws become extremely important for these situations.

The laws encourage young people to seek the health care services they need and allow them to speak candidly and confidentially with their health care providers.

Medical and dental services (ORS 109.640) Minors who are 15 years or older are able to consent to medical and dental services without parental consent.

This includes hospital care, as well as medical, dental, optometric and surgical diagnostic care. This would include services such as:

• Treatment for illnesses or injuries (colds, sprained ankle);

• Sports or camp physicals;

• Dental visits (check-ups, cleanings, fillings);

• X-ray services;

• Emergency room visits;

• Vision care (except for first time contact lens visit); and

• Immunizations.

A minor 15 years of age or older may give consent to diagnosis and treatment by a nurse practitioner who is licensed by the Oregon State Board of Nursing under ORS 678.375 and who is acting within the scope of practice for a nurse practitioner, without the consent of a parent or guardian of the minor.

Mental health and chemical dependency (ORS 109.675)

A minor who is 14 years or older may access outpatient mental health, drug or alcohol treatment (excluding methadone) without parental consent.

These services may include:

• Seeking help from a psychiatrist or psychologist;

• Seeking mental health therapy from a doctor or social worker; and

• Seeking help for drug or alcohol use.

Providers are expected to involve parents by the end of the minor’s mental health, drug or alcohol treatment unless:

• The parent refuses involvement;

• Clear clinical indications to the contrary exist and are documented in the treatment record;

• There is identified sexual abuse; or

• The minor has been emancipated and/or separated from the parent for at least 90 days.

109.675 Right to diagnosis or treatment for mental or emotional disorder or chemical dependency without parental consent.

(1) A minor 14 years of age or older may obtain, without parental knowledge or consent, outpatient diagnosis or treatment of a mental or emotional disorder or a chemical dependency, excluding methadone maintenance, by a physician licensed by the Oregon Medical Board, a psychologist licensed by the State Board of Psychologist Examiners, a nurse practitioner registered by the Oregon State Board of Nursing