January 31, 2006

Requiring health care professionals to report underage sexual activity?

The NYT reports:
A federal trial opened here Monday over whether a Kansas law prohibiting virtually all sexual activity by people under age 16 means health care professionals and educators must report such behavior to state authorities, which some say would stop many teenagers from seeking contraception or treatment for sexually transmitted diseases.

The class-action lawsuit stems from a 2003 opinion by the Kansas attorney general, Phill Kline, a conservative Republican who has developed a national reputation for fighting abortion....

Mr. Kline's interpretation of the law focused mainly on the reporting duty of abortion providers, arguing that any pregnant, unmarried minor had by definition been the victim of rape or abuse. But it included a broad mandate for reporting whenever "compelling evidence of sexual interaction is present."...

"If they know what they tell me is reported, they simply won't talk," said Beth McGilley, a Wichita therapist who is among the plaintiffs, referring to both teenage clients and adults who often consult her about their children's sexual exploration.
It's a harsh policy, but is it unconstitutional?
Bonnie Scott Jones, a lawyer for the Center for Reproductive Rights in New York, which is representing the plaintiffs, said in her opening statement that Mr. Kline's "dragnet approach" to amassing information on under-age sex violated minors' privacy rights and the Constitution's equal protection clause, and that it "seriously endangers the health and well-being of adolescents."...

Steve Alexander, an assistant attorney general defending the suit, said the Kansas statute meant that those younger than 16 could not consent to sex, and that those violating the law forfeited any privacy rights.

"Illegal sexual activity by minors can lead to S.T.D.'s, unwanted pregnancies, abortion, depression, mental illness," Mr. Alexander said. "To pretend otherwise is foolish."
Surely, you don't want to pretend anything foolish.

Actually, I'd like to see more of what the legal arguments are here. It looks as though the case is mostly about interpreting a state statute, but there is also a constitutional attack. Presumably, the constitutional attack is both part of the argument for narrowly construing the statute and a device to get the case into federal court. Shouldn't the federal court abstain and let the state court interpret the state statute?

11 comments:

Crazy Politico said...

I belive they probably added the equal protection arguement strictly to get it into federal court, since the Kansas courts would in all likelihood uphold the law.

That shouldn't stop the feds from dropping it back to the state though.

Steve Donohue said...

Abstinence is generally the best policy in these situations.

Nick said...

What about Dr. - Patient Priveledge? That is generally hold to be sacrosact unless there is a strong compelling state reason. One reason has been held to be that doctors have to report gun shot wounds to the police. But are the reasons here really compelling enough to destroy that priveledge?

Ann Althouse said...

The doctor-patient privilege is just a matter of state law. If the state chooses not to give it, that's the end of it.

reader_iam said...

I won't go on, 'cause it looks like this is shaping into a real law-discussion thread. But as non-lawyer, reacting to just the idea of the law itself, may I quote Dickens (out of context, granted)?

"...The Law is a Ass"

P_J said...

As a parent, I would like to know if my 13-year-old daughter had an abortion. Planned Parenthood doesn't want me to know, even though that's prima facie evidence of statutory rape.

It doesn't really matter whether the law stands or not because Planned Parenthood will continue to turn a blind eye, encourage girls to lie, and evade and ignore notification laws.

I suppose if I had a $100 million abortion business, I'd fight notification laws, too.

P_J said...

Just to be clear, I agree the Kansas law criminalizing all underage sex is extreme.

It's a shame that their stupid over-reaching means that we will lose an opportunity to discuss a very real problem.

Bruce Hayden said...

Health care providers in most, if not all, states already have a duty to report suspected abuse. That presumably is considered a compelling state interest, sufficient to overrule doctor / patient confidentiality.

I suppose that you could make the argument that this differs because of the privacy interests of the kids. But as one poster has pointed out, an abortion is prima facie evidence in many states of statutory rape, which is typically a felony, as is child abuse.

As the father of a daughter, I would want to know if she had an abortion for just this reason. I would want to know who the guy was, so that if he were a bit older, I would (try to) make sure that he was arrested and tried for statutory rape, at a minimum.

To this day, I fail to see why abortion is the one medical procedure where a parent is not legally required to be notified. There are real health issues involved, arguably much greater than, for example, tattoos which typically require parental permission, and the parents are supposed to deal with this in the dark.

I can just see it. A doctor tells parents that their daughter has bleeding and maybe sterile, but can't tell them why.

Indeed, sex and abortion are probably the only places where there is a doctor / patient confidentialty that excludes the parents.

It makes no sense to me whatsoever, esp. because, as noted, in many cases the whole situation is a result of the commission of a felony.

P_J said...

Me - ... because according to Kansas law, a 13-year-old cannot legally consent to sex. Age of consent laws are meant to protect minors - just as a 13-y-o cannot get a tattoo or ear piercing without parental consent.

Since pregnancy is prima facie evidence of sexual activity, that's statutory rape.

PatHMV said...

The trick will be to find a way to rule against this idiocy without also tossing out compulsory reporting of child abuse, gunshots, STDs (do they still have to do that with non-AIDS STDs?), and the like. Using the 1st Amendment forced-speech argument would undercut all those other reporting requirements, which are generally though to be worthwhile.

A Griswold argument coupled with a parental rights argument might be the best bet. Inherent privacy in the family and family planning along with the right of parents to make decisions about their child's upbringing without involving the state.

On the other hand, this may just be a really bad, stupid, short-sighted policy that Kansans should quickly overturn if they don't like it.

P_J said...

Good comments. As I said, I think the law and especially this application is over-reaching. I suppose Planned Parenthood is right to draw out some of the logical conclusions of where this law would lead, but consent laws really do serve a good purpose.

I'm not sure healthcare providers should have to tell the authorities that they gave birth control to a 15-year-old. But the law (and healthcare workers) should protect the best long-term interests of minors - precisely because they lack the wisdom and maturity to make wise decisions for themselves.

Where do you draw the line? What if a 15-year-old is having risky sex with multiple partners? Do you notify the parents of a 16-year-old with an STD? Do they need to know (even if only for medical reasons) if a minor daughter is taking birth control pills?

As an earlier commenter asked, Why are sex and abortion singled out as areas of their children's health in which parents cannot know anything? Why must a 12-year-old get permission for ear piercing but not for abortion - which is physically and morally a much more significant act? Could you imagine rushing a 14-year-old to the ER with appendicitis, operating on him, sending him home and never saying anything about it to his parents?