Mature Minor

Alabama maintains very broad statutes pertaining to the ability of minors to consent to general health care without needing additional parental consent. In Alabama "any minor who is age 14 or older, or has graduated from high school, or is married, or having been married is divorced or is pregnant may give effective consent to any legally authorized medical, dental, health or mental health services, and the consent of no other person shall be necessary."¹⁹⁷

Passed in 1975, this statute places Alabama at the forefront of children's rights as pertaining to health care access.¹⁹⁸ By allowing minors age 14 or older the unfettered right to consent to general health, dental, and mental health services, it appears that Alabama, in effect, recognizes that many minors have the experience and judgment to make fully informed decisions.¹⁹⁹ By not requiring the minor to be financially independent or live separately from her parents or legal guardian, this statute acknowledges the importance of minors' privacy rights. In effect, it shows that parents do not have an absolute right to make health care decisions for their children, even though they are living in the same household. In addition, since age acts as the bright line rule determining ability to consent to general health care, Alabama effectively rids its laws of inconsistencies in determining which health care issues are worthy of minor consent alone, as well as inconsistencies in dealing with a vague maturity standard for those at least 14 years old.

Moreover, by including high school graduates among those with the right to consent to health services, Alabama acknowledges the potential difficulty that this group of minors may face. The inequitable reality for some high school graduates may be that they are independent from their parents and yet, traditionally, still cannot consent to their own health care since they have not reached the legal age of majority - even if only a few months shy of their 18th birthday. While Alabama's broad 14 year-old age status takes care of all high school graduates, this offers added protection and another option for Massachusetts to consider.

Further, Alabama acknowledges that any minor, even those under the age of 14, may have health care concerns dealing with traditionally sensitive and urgent issues, such as pregnancy, STDs, alcohol, or drug abuse.²⁰⁰ Alabama Code § 22-8-6 gives ``any minor,'' regardless of age, the ability to "give effective consent for any ... health services to determine the presence of, or to treat, pregnancy, venereal disease, drug dependency, alcohol toxicity, or any reportable disease." This statute respects minors' right to privacy, independent of age, when these specific health concerns surrounding issues of immediacy, confidentiality, and important policy implications are present.

While broadly supporting the rights of minors to consent to general health care, Alabama also protects health care providers from liability for treating a minor who is under the age of 14. Under Alabama Code § 22-8-7 (2000), ``any physician or other person who has relied in good faith upon the representations'' of a minor who misrepresents herself will not be held liable for not gaining proper consent.

In sum, Alabama's statutory scheme has remained unchanged since enactment in 1975, and there appears to be only one case citing the general health consent statute, which case deals with the issue of abortion and parental notification.²⁰¹ Without any amendments or oppositional case law, this suggests that Alabama has found the bright-line age test to work well. Therefore, Alabama's broad statutory scheme offers a good model for Massachusetts to follow in expanding its Mature Minor Rule, especially when considering a bright-line age recommendation for drafting expanded mature minor legislation.

Footnotes

...¹⁹⁷

Ala. Code § 22-8-4 (2001).

...¹⁹⁸

See The Alan Gutmacher Institute, supra n. 126; South Carolina also maintains a broad medical consent statute whereby any minor 16 years of age or over may consent to health services other than operations. S.C. Code Ann. § 20-7-280 (2001).

...¹⁹⁹

See The Alan Gutmacher Institute, supra, n. 129.

...²⁰⁰

Ala. Code § 22-8-6 (2001).

...²⁰¹

See Arnold v. Board of Educ., 754 F.Supp. 853, 859 (S.D. Ala. 1990). This case mentions Ala. Code § 22-8-7 in the context of a 15-year-old minor who consented to an abortion without informing her parents and where the school officials also did not inform the parents or have a duty to notify. While the holding does not deal specifically with the statute, the court granted summary judgment for the defendant school officials, which lends support and credibility to the statute.