Let Doctors Be Doctors

Originally posted at YDNC.org. Dr. Matthew Pepper is the President of the Durham County Young Democrats.

The relationship between a primary care physician and a patient is special. As a pediatrician, I experience the joy of watching newborns grow into rambunctious toddlers, inquisitive children, headstrong teenagers, and then eventually mature into healthy adults. Through my years of taking care of families, I learn intimate details of their physical and emotional lives. It is my duty to use this information to keep my patients healthy and guide them through all the pitfalls of life. Unfortunately, North Carolina General Assembly House Bill 693 could form an unnecessary and potentially dangerous roadblock for physicians trying to care for their patients.

HB 693 is a proposal to amend North Carolina’s current law protecting minors who wish to seek treatment for sexually transmitted diseases, pregnancy, mental illness, and substance abuse. Under current law, any minor who wishes to seek treatment may do so confidentially. If this bill passes, patients would either need their parents physically there to consent or a letter signed and notarized that grants permission for the child to seek treatment.

This bill will cause an increase North Carolina’s sexually transmitted disease rate. This bill would make North Carolina the only state in the nation to require parental consent to treat a sexually transmitted disease. I can tell you from personal experience (and from scientific studies) that when they know a parent has to be involved, most teenage patients will instead deny any sexual activity. The problem is not just on the patient side; parents too will sometimes willfully ignore the possibility that their child is sexually active, even if such denial can cause serious medical consequences. According to the CDC, North Carolina ranked 14th in the nation in 2009 for rates of chlamydia. Almost half of these cases were in patients aged 15 – 24. The results of these illnesses can be devastating, ranging from hospitalization to infertility. Still, we cannot treat what we do not know about. We cannot be creating extra barriers to those who need care.

This bill will cause a rise in pre-term birth and medical complications from pregnancy. One of the best things we can do for women who are pregnant is get them set up with early and complete prenatal care. Lack of prenatal care can increase the risk for both the pregnant mother and the developing child. This can lead to a multitude of problems, including a risk of pre-term labor, birth defects, and even fetal demise. A patient who is concerned about pregnancy is going to be much less likely to be honest with her doctor if she knows she needs to talk to her parents first. This bill will only increase the rate of those who fail to seek proper care.

This bill will endanger the lives of those most vulnerable. Discussions about mental health, sexuality, and substance abuse are difficult to have. Although we always encourage our patients to have an open and supportive relationship with their parents, there are circumstances where such a relationship may not be possible. No legislation can change that.

I once treated a patient whose parents were going through an acrimonious divorce. The stress of his family situation was taking a psychological toll on my patient, leading to anxiety and depression. His father, still one of his legal guardians, forbade the patient from seeking any treatment for his psychiatric illness. Seeing a specialist was out of the question. Only because my patient was able to see me confidentially could he actually get help for this problem that was affecting almost all aspects of his life. Without such treatment, he could have ended up failing out school, spiraling into drug use, or worse, taking his own life.

Parents do not want this law passed. Although this is framed as an issue of parental rights, a recent survey commissioned by the Adolescent Pregnancy Prevention Campaign of North Carolina actually talked to parents of school-age children in North Carolina and found that 83% of parents support the current consent law. This cuts across party lines. In the same study, even 76% of Republicans supported keeping the current law.

HB 693 is simply bad bill, “fixing” a problem in the system that does not exist. Please talk to your representative about why YOU oppose such a measure. You can find your representative here.

Being a medical professional can be a demanding job at times, but we choose this profession because we truly love to help those we can. We cannot let the state government get in between doctors and patients. The future of our state is too important for that.

Comments

Immaculate Conception

Did Mary, Mother of God, have to get parental consent?

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The measure of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little. - FDR

Unintended consequences

1. Would members of the military under the age of 18 serving in NC be required to obtain parental consent prior to seeking medical treatment covered by the bill?

2. Would persons under the age of 18 who are legally married be required to obtain parental consent prior to seeking medical treatment covered by the bill?

3. Would victims of statutory rape under NC law be required to obtain parental consent prior to seeking medical treatment covered by the bill?

4. I could not find in the bill the penalties or sanctions for violating the parental consent provisions. Perhaps that is outlined elsewhere in the existing statute.

Perhaps those under items 1 and 2 are considered emancipated minors under current law.

Obviously that level of detail is insignificant in the pursuit of ideological bumper sticker slogan solutions to non-existent problems.

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The measure of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little. - FDR