State-by-State Variability in Adolescent Privacy Laws
State-by-State Variability in Adolescent Privacy Laws
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DOI：
10.1542/peds.2021-053458
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发表时间：
2022-06-01
期刊：
影响因子：
8
通讯作者：
Rosenbloom, S. Trent
中科院分区：
文献类型：
--
作者：
Sharko, Marianne;Jameson, Rachael;Rosenbloom, S. Trent
目的：管理青少年复杂健康需求的卫生保健提供者必须遵守有关青少年同意和隐私权的州法律。然而，这些法律各不相同。我们的目标是总结各州的同意和隐私法，并评估遵守《21世纪治愈法案》和青少年护理循证指导的变化的含义。方法：我们总结了以下方面未成年人同意的国家法律法规：卫生服务、药物滥用治疗、产前保健、精神保健、避孕管理、免疫接种、性传播感染管理、人类免疫缺陷病毒检测和治疗、牙科保健和性侵犯评估。我们将各州法律法规与美国儿科学会的循证指南进行比较，以评估指南的一致性。结果：我们观察到各州在青少年患者同意法律方面存在显著差异。没有哪个州对所有被研究的服务都有相同的政策。例如，虽然所有国家都有关于同意管理性传播感染的规定，但在未成年人的年龄和类型、是否包括人体免疫缺陷病毒以及是否保护保密等方面都有不同的规定。向青少年病人提供保密护理已被医疗协会定为优先事项；然而，由于需要遵守国家法律法规，指导方针受到限制。结论：各州关于青少年同意和隐私的法律差异很大，许多法律不能反映儿科专业护理标准。这种不一致是实施一致和公平经验的障碍，无法提供循证医疗保健和确保青少年隐私保护。
OBJECTIVES: Health care providers managing the complex health needs of adolescents must comply with state laws governing adolescent consent and right to privacy. However, these laws vary. Our objectives were to summarize consent and privacy laws state-by-state and assess the implications of variation for compliance with the 21st Century Cures Act and with evidence-based guidance on adolescent care.METHODS: We summarized state laws and regulations on minor consent for the following: health services, substance abuse treatment, prenatal care, mental health care, contraceptive management, immunizations, sexually transmitted infection management, human immunodeficiency viruses testing and treatment, dental care, and sexual assault evaluation. We compared state laws and regulations with American Academy of Pediatrics' evidence-based guidelines to assess consistencies in guidance.RESULTS: We observed notable state-by-state variability in laws governing consent for adolescent patients. No states had identical policies for all services studied. For example, although all states had provisions for consent to management of sexually transmitted infections, there were variable specifications in the age and type of minor, whether this includes human immunodeficiency viruses, and whether confidentiality is protected. Providing confidential care to the adolescent patient has been set as a priority by medical societies; however, guidelines are limited by the need to comply with state laws and regulations.CONCLUSIONS: State laws on consent and privacy for adolescents are highly variable, and many do not reflect pediatric professional standards of care. This inconsistency is a barrier to operationalizing a consistent and equitable experience providing evidence-based medical care and ensuring adolescent privacy protection.