The MMR acts as a constraint for at-risk youths and health care providers in various ways, including those mentioned above surrounding the inconsistency of granting minors the right to consent to some health care, but not all. A further constraint consists of a lack of knowledge on the part of health care providers regarding what this statute covers or does not, and even the existence of this statute.103 Providers need to be educated about when they legally need to obtain parental consent and when it is not necessary. Indeed, providers may feel caught in a tug-of-war, since they may believe that parental consent is necessary, while they have also been told that they could be just ``as liable for not [giving treatment] as you can be for [giving treatment],''104 especially if the minor suffers a negative consequence after the provider refuses to give treatment without parental consent.
Additionally, minors who graduate high school prior to the age of 18 may face a constraint in receiving health services. For some, the unfair reality may be that although they are independent from their parents in many ways, they are legally not permitted to consent to their own health care. While the number of minors facing this dilemma might be small, it is nevertheless a constraint of the current MMR. In expanding this statute, Massachusetts could look to Alabama, which expressly acknowledges this group's predicament by including the phrase ``graduated from high school'' as one of its criteria for permitting minors' consent.105
Recommendations to further the goals of expanding the MMR include interviews with at-risk and homeless youth to learn how the current statute specifically impacts this population, as well as working toward educating health care providers about the MMR.