No.  Consent for treatment for drug use, drug abuse, alcohol use or alcohol abuse by a minor is as binding as if a person who had reached the age of majority and requires the consent of no other person, including parents or guardians.  Treatment consented to, by the minor, is confidential information between the physician, treatment facility or provider and the minor.  N.J.S.A 9:17a-4

·         What if a minor who has overdosed is brought to the Emergency Department, requires stabilization and treatment?  Do the same rights apply?

Yes.  You do not require the consent of a parent or guardian, as long as the medical or surgical treatment provided is for the minor’s drug use, drug abuse, alcohol use or alcohol abuse. Specifically, N.J.S.A. 9:17A-4 provides that when a minor believes that s/he is suffering from the use of drugs and/or alcohol or is dependent on drugs and/or alcohol, s/he may consent to confidential treatment, as long as the treatment provider is a licensed physician, licensed or certified alcohol treatment specialist or licensed treatment facility, just as if s/he had attained the age of majority. 

·         A minor has mental health issues and requires treatment.  Is there a duty to inform his/her parents or guardian?

Yes.  Typically, minors in New Jersey have the right to consent, on their own, to treatment involving contraception, pregnancy, abortion, sexually transmitted diseases and substance abuse.  Mental health issues falls outside those defined parameters and requires parental notification.

·         The minor is insured through a parent’s or guardian’s private health coverage.  Can I still ensure confidential treatment?

No.  Minors must be aware that if they are covered under their parents’ health insurance and s/he intends to utilize it for payment for services rendered, a statement of benefits may be sent, as a matter of course, by the insurance company to the policy holder.  Additionally, some insurers may not authorize payment for treatment rendered to an unaccompanied minor.

·         The minor child is obtaining treatment for pregnancy, contraception or abortion care using Medicaid. Is confidentiality ensured through this insurance?

Yes.  Federal laws protect the minor receiving family planning treatment and care for services obtained under Medicaid.  Those health facilities that receive federal funding under Title X of the Public Health Services Act must provide confidential family planning services to minors.

·         I have reason to believe that the minor is being physically or sexually abused.  What are my obligations to report?

You must immediately report.  Under N.J.S.A. 9:6-8.10, an “abused child” is defined as any minor under the age of eighteen (18) whose parent, guardian or someone in control subjects the minor to harmful acts or omissions of care.  This may include, but is not limited to, the failure to provide the basic necessities of adequate food, clothing, shelter, excessive corporal punishment, excessive physical restraint or willful abandonment.  New Jersey statute requires any person who has reasonable cause to believe that a child is being abused to immediately contact the Division for Youth and Family Services.

·         A child who is accompanied by a parent or guardian requests confidential treatment.  What are my obligations to inform the parent?

 This is a murkier situation to maneuver.  Although you may follow the guidelines above, the physician should be assessing the minors age, maturity and level of understanding.  Ambiguities in the rights of minors to obtain confidential medical treatment may be resolved by getting a parent or guardian to assent to an agreement of confidentiality.  ACLU: Guide to Minors’ Right to Confidential Reproductive Healthcare, January 2006, citing 42 U.S.C 300(A)L 42 C.F.R. 59.5(a)(1); 42 U.S.C. 1396D(a)(4)(C). In those instances, a federal privacy regulation specifically protects a minor’s right to confidentiality when a parent or guardian signs a waiver of assent. (Id.)

Treating minors can be a confusing endeavor, particularly when rendering care for services where they may have the authority to consent to treatment.  At times, state law may be preempted by federal law, or be trumped by the minor’s Constitutional rights.  At this juncture,  minors have the right to render consent for treatment in a number of situations including those services involving contraceptive counseling and services; abortion; pregnancy related medical care; testing and treatment for sexually transmitted diseases; and treatment for sexual assault.  However, it is important to assess the minor’s judgment, maturity and implications of the treatment sought and the ultimate goal of providing timely and appropriate care.