Calderon Susana J, Mallory Caroline, Malin Michelle
1 Mennonite College of Nursing Normal, Illinois State University, IL, USA.
2 College of Health and Human Services, Indiana State University, IN, USA.
Policy Polit Nurs Pract. 2017 Nov;18(4):186-194. doi: 10.1177/1527154418763115. Epub 2018 Apr 3.
While most states allow minors 12 years and older to consent to services for contraception, prenatal care, or sexually transmitted infections, the same adolescents are required to have parental consent for even preventive oral health care. Many adolescents are denied access to preventive oral health care because of the challenge of securing parental consent for care when parents are unwilling, unable, or unavailable to consent. Our purpose is to examine the barriers to preventive oral health care for U.S. adolescents related to parental consent laws, explore the issues surrounding these laws, and recommend policy changes. We explain the current range and status of consent laws across the country and arguments for parental consent law as it now stands. We discuss the difficulty of applying general medical consent law to preventive oral health care, neuroscience research on cognitive capacity among adolescents, and the distinction between parental consent and adolescent assent. We recommend replacing required "opt-in" consent with simpler "opt-out" consent; developing a tool for assessing adolescent decision-making capacity; advocating for consent laws that apply specifically to preventive oral health care; and empowering school nurses to lead local, state, and nationwide policy and legislation efforts.
虽然大多数州允许12岁及以上的未成年人自行同意接受避孕、产前护理或性传播感染方面的服务，但同样这些青少年即使接受预防性口腔保健也需要获得父母的同意。许多青少年由于在父母不愿意、无法或不能同意时难以获得父母对护理的同意，而无法获得预防性口腔保健服务。我们的目的是研究与父母同意法相关的美国青少年获得预防性口腔保健的障碍，探讨围绕这些法律的问题，并建议政策变革。我们解释了全国同意法的当前范围和状况以及现行父母同意法的论据。我们讨论了将一般医疗同意法应用于预防性口腔保健的困难、关于青少年认知能力的神经科学研究，以及父母同意和青少年赞同之间的区别。我们建议用更简单的“退出”同意取代要求的“加入”同意；开发一种评估青少年决策能力的工具；倡导专门适用于预防性口腔保健的同意法；并授权学校护士引领地方、州和全国性的政策及立法工作。
