NJ's A4149/S275 Continues the Assault on Parental Rights

Assembly Health Committee will vote on Monday

According to Melissa Alfieri-Collins, BSN, RN:

On Monday, Assembly Health has both A4149 and it’s Senate companion bill S275 on the agenda.

This bill permits Pharmacists to furnish self-administered hormonal contraceptives pursuant to a standing order. This includes self-administered hormonal contraceptive (ie. oral, transdermal, or vaginal contraceptive product, including, but not limited to, birth control pills, vaginal rings, and diaphragms).

No minimum age is mentioned.

No parental consent required.

No prescription needed.

The patient will have to complete a self screening tool that may indicate risk, however, their primary doctor is not involved in this decision.

Just another bill to remove the parent from the equation.

shared with permission

You can read the bill here.

The eroding of parental rights is not new. This has been a gradual chipping away of parental consent and evidence of it can be seen everywhere. Here is some background with regards to where we stand with parental consent as well as parental notification and minor’s access to birth control…

From a 2018 article in U.S. Pharmacist:

At the federal level, the Title X Family Planning Program issues grants to clinics across the country that provide family planning and related preventive health services. Adolescents who receive care at one of these federally funded facilities are not required to have their parents’ or guardians’ consent to obtain hormonal contraceptives or other preconception healthcare services. The clinic is not permitted to notify the minor’s parents or guardians about the services received. Additionally, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) contains provisions addressing the issue of minors and the privacy of their health information.

Whether minors can or cannot consent to medical treatment is not within the scope of the HIPAA Privacy Rule, which “addresses access to, and disclosure of, health information, not the underlying treatment.” Although the Privacy Rule allows parents access to their child’s healthcare records “when such access is not inconsistent with State or other law,” there is a notable exception wherein disclosure of the minor’s records is not permitted. The parent or legal guardian should not be given access “when the minor is the one who consents to care and the consent of the parent is not required under State or other applicable law.” As a result, laws on the state level provide important insight into the rights of minors consenting to hormonal contraceptives.

Almost every state has passed laws or policies that permit minors to consent to contraceptive services. States may allow all minors to consent to hormonal contraceptives or just minors meeting specified characteristics, such as being married or attaining a certain age.6 Along with the ability to consent to contraceptives, state laws usually include privacy or confidentiality regulations with regard to parental notification.

You can learn more about your state laws and policies regarding minor’s access to contraceptive services here.

Over the past 30 years, states have expanded minors’ authority to consent to health care, including care related to sexual activity. This trend reflects the 1977 U.S. Supreme Court ruling in Carey v. Population Services International that affirmed the constitutional right to privacy for a minor to obtain contraceptives in all states. It also reflects the recognition that while parental involvement is desirable, many minors will remain sexually active but not seek services if they have to tell their parents. As a result, confidentiality is vital to ensuring minors’ access to contraceptive services.

And considering the “close in age exemption” with regards to the age of consent to have lawful sex, kids as young as 13 can be engaging in consensual sex.

NJ’s age of consent is 16 years old. However, “a close in age exemption exists allowing minors between ages 13 and 15 to engage in sexual congress with a partner up to 4 years older.”

Do we really believe a 13 year old is capable of true informed consent for self-administered hormonal contraceptives? What happens when children - who have opted to get these medical interventions without the knowledge or consent of their parents - experience an adverse reaction? What happens when something goes wrong and parents have no way to understand what’s is afflicting their child?

This legislation is also a blow to the practice of medicine and the doctor-patient relationship. What does a pharmacist know about your health history? Who is responsible if something goes wrong?

I don’t think Senate Health Committee Chair Joe Vitale has thought this through.

If you’re in NJ, you can find your legislators here. Reach out and let them know how you feel.