Consent, Confidentiality, & Access: How Parental Consent Laws Benefit Adolescents

The foremost considerations when debating the merits of a parental consent law are doctor-patient confidentiality and access to health care.

Confidentiality, first of all, has proven to be of crucial importance in getting adolescents to use health care, particularly with regards to reproductive issues [1]. This is obviously not, however, a fact unique to adolescents, though it is certainly portrayed that way. Under the HIPPA privacy law in the United States, abortion is grouped with HIV/AIDS and sexually transmitted infections in that patient confidentiality may be maintained following court consent, but treatment or action cannot occur without adult consent. A minor may request court approval of consent if she is unable or unwilling to tell her parents, similar to what we are seeking in Saskatchewan.  Confidentiality is not broken in that parents are told in secret. Adolescents are made aware of the requirement and informed of the need for parental consent before contact is made, and given the knowledge that they have the opportunity to seek court consent instead if necessary.

Access to health care, then, is the other major consideration.  Such access can actually be improved by a parental consent law.  It can be very difficult for adolescents to navigate the health care system on their own, from making appointments to transportation to appointments to accessing the follow-up care they may need.  Absences from school or home will need to be explained, and the stress of dealing with pregnancy alone is obviously significant for an adolescent.  Studies show that adolescents often know later in their pregnancy that they have conceived, or at least do not seek medical attention until they are “beyond facilities’ gestational age limits”. [2] While Canada has no laws restricting abortion, most doctors will only perform abortions before the 20 week mark, as after this point the fetus is considered viable. If the adolescent does present early enough for a drug-induced medical abortion, the complication and failure rates are higher than for surgically-induced abortion, so parental involvement and care can be very valuable [3].  

An adolescent who gets an abortion in secret is more likely to hide her pain and complications following the procedure, putting her health at risk, and parents will not know to watch for signs of physical or psychological struggling. Studies have found a significantly higher rate (3-6x) of suicide in 15-24 year olds following induced abortions when compared to those who are not pregnant or who chose childbirth when pregnant, as well as decreased self-esteem and feelings of guilt, fear and confusion over what occurred [4-7]. A review of the literature from 1995-2011 found that pregnancy loss, including through abortion, carries a higher risk of subsequent mental disorder than childbirth. Thirteen studies showed a clearly higher risk for the abortion group versus those who chose childbirth, while only 5 studies found no difference [8].

The Canadian Medical Association, in its official policy on induced abortion, stresses the need for full and immediate counselling services for patients in the case of an unwanted pregnancy. This is much easier to ensure and maintain with parental consent requirements in place [9]. Helping or encouraging adolescents to keep their  pregnancies and abortions secret is helping them isolate themselves at a particularly vulnerable time, at an age where their coping mechanisms are not yet well-developed. That doesn't sound like a consideration of best interests at all.

We must briefly consider the concern that is sure to be raised in dramatic fashion almost immediately. Is there the possibility that parental consent requirements will drive some adolescents to self-harm or illegal abortions, or the now-infamous "coat hanger argument"? This has always held true for a small, sensationalized minority of cases, and will continue to do so. Desperate young women, like desperate older women, will take desperate measures. This does not, however, negate the need for a parental consent law with all its potential benefits for the majority. Rather than abandon parental consent, we should instead focus on alternate front-line support for these women who feel their situation is so dire they cannot possibly share the news of a pregnancy with an adult.

In terms of decision-making and consent, the terms mature or immature are not meant as a comment on an adolescents’ character or intellect, but rather as a scientific  reality in terms of brain development. Not only are adolescents likely to make their pregnancy-related decisions in a state of stress, emotion, and exhaustion, they are also doing so with a less-developed prefrontal cortex than an adult, one of the “key ways the brain doesn’t look like that of an adult until the early 20s” [10]. Adolescent brains show marked differences not in intellectual ability compared to adults, but in areas of impulse control and planning for the future.  Those last-to-develop capacities are critical to making an informed decision on parenthood. These abilities are accessible in their parents, who can assist them in reasoning beyond the emotional basis, and beyond what peers are capable of.

In addition to the incomplete brain development of adolescents, there are marked hormonal shifts occurring in adolescence.  These shifts affect the intensity with which emotion is felt as well as stress levels. Add to that the hormonal shifts that come with pregnancy and you have a dangerous decision-making cocktail which, like many cocktails, will lead to regretted decisions.

The argument put forward regarding adolescents needing consent to continue with a pregnancy should be dismissed without further consideration.  Just as parental consent is needed for any surgery, so it should be needed for abortion at any stage of pregnancy. We do not ask for parental consent for an adolescent to get appendicitis or cancer, we simply involve them in helping their child cope with the consequences. As stated in R. v. Morgentaler, abortion is not a right, and should not be treated as such [12].

Parental consent does not equal parental control - it is about responsibility and care. The term consent implicitly states that the decision belongs to the adolescent. Her parents can share their reasoning and attempt to influence her decision, but the main goal is to provide support for pregnant adolescents regardless of the outcome of their pregnancy.  Whether they choose abortion, adoption, or active motherhood, support is crucial to their success and well-being.  A parental consent law makes it clear that the government supports young women as well as the lives they may carry, and is working to enhance their well-being now and across their lifespan.


1 English, A. & Ford, C. (2004). The HIPAA privacy rule and adolescents: Legal questions and clinical challenges. Perspectives on Sexual & Reproductive Health, 36 (2)

2 Dobkin, L., Perucci A. & Dehlendorf, C. (2013). Pregnancy options counseling for adolescents: Overcoming barriers to care and preserving preference. Adolescent Pregnancy, 43 (4), 96-102.

3 Lanfranch, A., Gentles, I. & Ring-Cassidy, E. (2013). Complications: Abortion’s Impact on Women. The deVeber Institute for Bioethics and Social Research, ON, Canada.

4 Ely, G., Flaherty, C. & Cuddeback, G. (2010). The relationship between depression and other psychosocial problems in a sample of adolescent pregnancy termination patients. Child & Adolescent Social Work Journal, 27 (4) 269-282.

5 Gissler, M., Hemminki, E., Lonnqvist, J. (1996). Suicides after pregnancy in Finland, 1987–94: register linkage study. BMJ 313: 1431.

6 Curley, M. & Johnston, C. (2013). The characteristics and severity of psychological distress after abortion among university students. Journal of Behavioral Services & Research, 40 (3), 279-293.

7 Humphrey, M., Colditz, P., Flenady, V. & Whelan, N. (2013) Maternal and Perinatal Mortality and Morbidity in Queensland Queensland Maternal and Perinatal Quality Council Report 2013. State of Queensland (Department of Health). Retrieved from

8 Bellieni, C. & Buonocore, G. (2013). Abortion and subsequent mental health: Review of the literature. Psychiatry & Clinical Neurosciences, 67 (5), 301-310.

9 CMA Policy: Induced Abortion.

10 The teen brain: Still under construction.

11 Canadian Medical Association, Code of Ethics, 2004.

12 R. v. Morgentaler (1988) 1 SCR 30, 1988 CanLII 90 (SCC). Retrieved from



2015 March for Life

Consider joining us on the steps of the Legislature for the annual March for Life!

If you would like a PDF of the poster so that you can share with others please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it. 


Doctor's note required to use chapstick in school

news story has been making the rounds about a ridiculous elementary school regulation against students’ use of lip balm. A fifth-grader named Grace Karaffa requested some Chapstick while on the playground and was denied.

Eleven year-old Grace started a petition to allow Stuarts Draft Elementary School students to use the product and gained 236 signatures before testifying to the school board.


She explained, “I was told I couldn’t use it. Then later that day, they started to bleed so I asked for Chapstick again and I was told that it was against the school policy for elementary kids to have Chapstick.”

The assistant superintendent of administration for Augusta County Public Schools informed reporters that Chapstick is considered an over-the-counter medication by the school board. In Augusta County Public Schools, Chapstick may only be administered by a school nurse and only if a physician has prescribed its use.

This may seem like a somewhat silly story about bureaucracy gone too far. However, it is outrageous and infuriating when you consider that a child may need a physician’s note to apply Chapstick — but, in 26 states and Washington, D.C., teenagers and pre-teens don’t even need parental permission to obtain an abortion.

An 11 year-old girl has to apply to her school district’s board to be able to use Chapstick on her chapped lips. Yet in some states, if an 11 year old girl wants a life-altering and potentially life-threatening surgical procedure, nobody has to know. In many other states, parents, guardians or even just a sibling or “mental health professional,” need only be informed of this child’s decision.

I’m not a parent, and I’m certainly not a lawmaker, doctor or an abortionist. But I’ve been an 11-year-old before, and I’ve known many in my life. I can say with perfect conviction and scientific backing: grave consequences result when 11 year-olds are allowed to make irreversible decisions which will affect the course of their lives forever. In fact, recent studies reveal their minds aren’t even yet fully formed to understand the long-term implications of their choices.

When the conscience of a nation has turned so absolutely upside-down that something helpful is forbidden, but something absolutely harmful is accepted without a second thought, the only solution is an appeal to the Creator of the human conscience — the One who wrote His law on the hearts of men.

This story originally was published at

She didn't want to disappoint her parents, so she aborted their grandchild

This article was first published at

When a bill requiring minors getting abortions to inform their parents was being considered, a blogger posted some stories from teenagers speaking out either in favor or against the bill. This young man was the father of an aborted baby.

He argues against the bill, believing minors should not have to tell their parents:


“My girlfriend Jenay had an abortion and the baby was mine. I met her at John Muir Middle School in Oakland. We were both 14. She was 15 when she had an abortion….

“She had the abortion because she didn’t want her father to hate her. She didn’t actually know if he really would have hated her, but they had some talks in the past and he told her she should wait to have sex and that he would be disappointed if she got pregnant…..

After she had the abortion I felt really bad and relieved at the same time.I felt bad because we killed my son or daughter. I was relieved because I didn’t have to go through the drama that might have occurred with my family and I if they found out.”

“Post-abortive teens on Proposition 73” JivinJeoshaphat Wednesday, November 09, 2005

He seems to realize that a baby died in the abortion, his own son or daughter. He doesn’t seem to care very much however. But when pro-lifers say that teenagers should get the consent of their parents or at least have to notify them before they get an abortion, pro-choicers insist that teens already tell their parents that the only teens who don’t are those in abusive families.

This girl didn’t involve her parents in the decision because she was afraid they would be disappointed with her –not because  they were abusive; they do not threaten her, they were nonviolent. She could’ve gone to her parents, and this may have had a different outcome if she had.

At the very least, she would not have had to go through a major surgical procedure alone at 15, and been forced to handle any possible aftereffects or complications in secret.It is hard to understand how this is in the best interests of minors. Note: Sarah Terzo is a pro-life liberal who runs, a web site devoted to exposing the abortion industry. She is a member of the pro-life groups PLAGAL and Secular Pro-Life.


This public awareness campaign is a joint effort between Saskatchewan Pro-Life Association and For more information please contact us here.

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