Med [& Law]: Medical Emancipation…and the stupidity of compromise

February 8, 2008

First off, I want to preface this post by saying that what I’m talking about only applies to Illinois Health Care Law. Given that statutes about healthcare vary IMMENSELY from state to state, I have no idea to which others these will apply–and I don’t intend on looking them up. I pretty much plan to live and practice medicine in Illinois for the rest of my life, so I don’t wanna confuse myself with OTHER states’ laws.

Let me start with some background.

We’ve been talking a lot lately about when minors are considered emancipated; that is, when they are allowed to make their own medical decisions and have their medical information withheld from their parents. Minors can apply for emancipation for a few different reasons, and some of them require court proceedings. Illinois statute permits all minors to make healthcare decisions for themselves–with parental involvement–if certain conditions are met. Pertinent to our discussion is the following:

“And, for such purpose, a married person who is a minor, a parent who is a minor, a pregnant woman who is a minor, or any person 18 years of age or older, is deemed to have the same legal capacity to act and has the same powers and obligations as has a person of legal age. (410 ILCS 210/1)

So basically, if a girl is pregnant she can be considered emancipated. Fair enough. Neither she nor her doctor are required (her) or allowed (doctor) to tell her parents about the pregnancy and subsequent care. Of course it’s usually in the best interest for them to know, but that’s not what we’re discussing right now. There are certain things we should notice about this. She is emancipated WHILE pregnant or if she is a parent. If she has a miscarriage or an abortion, she is NO LONGER EMANCIPATED if she is still a minor. If the girl has a live birth, she is then considered a parent and is therefore permanently emancipated–you cannot lose parent status if the child later dies.

Stillbirth is more of a gray area for this, since the female never actually gives birth to a live baby.There’s a lot of debate, especially in regards to the issuing of birth certificates. By definition, birth certificates signify live births–so they are not appropriate for stillborns. Yet, parents ARE issued death certificates…and how do you have death without birth? From what I remember, stillbirth DOES NOT emancipate a female in Illinois–but I am admittedly unsure about this.

——————-

So after that lengthy background, let’s get to my problem with what we addressed–specifically, let’s talk about abortion.

OK. So when a girl decides to get an abortion, that is HER business. She is pregnant and therefore considered emancipated. She could have been seeing a doctor without her parents knowing about it, and they might not even have ANY IDEA that she’s pregnant. The girl had no legal obligation to tell them, and the doctor had not legal right to tell them. But here’s where it gets tricky.

According to the Parental Notice of Abortion Act of 1995 (750 ILCS 70/1), a physician has an obligation to notify the parents of the girl that she is getting an abortion at least 48 hours prior to the procedure. This statute REEKS of lobbyist influence & political maneuvering/compromise and simply does not make sense. The statute states:

“The medical, emotional, and psychological consequences of abortion are sometimes serious and long‑lasting, and immature minors often lack the ability to make fully informed choices that consider both the immediate and long‑range consequences. “

Fine, I suppose. But does pregnancy not ALSO have serious consequences? If we’re going to give emancipated status to a minor that is pregnant and subsequently a parent, why does this minor lose medical privacy specifically when getting an abortion? The abortion is occurring while emancipated. And her parents would not be notified if she was going into labor or if she miscarried–only when she is seeking an abortion.

Talk about a tumultous 48 hours. Not only is the girl getting an abortion, but NOW she has to deal with her parents–whom I’m assuming don’t know ANYTHING yet–finding out that:

a) She’s sexually active

b) She’s pregnant

c) She’s getting an abortion

d) She was withholding ALL OF THIS from her parents

How in the hell is this girl supposed to be getting an abortion after all of this? Are the parents just going to step aside and say, “OK honey, go ahead and deal with it.” Hardly. They’re going to be mad about the entire situation and possibly attempt to stop it. And how is this not violating her medical privacy to which SHE IS ENTITLED by being emancipated?

It’s a topic that really bugs me–and will likely come up in my health insurance discussion sometime within the next few days. The only way anything can get passed as legislation is through massive amounts of compromise that cripple its very effectiveness. So what’s the point?

OK. I think that’s enough for now.

If for some reason, you want to read the Emancipation of Mature Minors Act in its entirety, here it is:

Emancipation of Mature Minors Act

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