Az children’s medical confidentiality would be eliminated under GOP proposal

Arizona children wouldn’t be able to
count on the confidentiality of their doctors under a Republican
proposal that the American Civil Liberties Union warns will turn minors
away from health care providers.

The legislation would give parents
unfettered access to their child’s medical records upon request, unless
the minor secures confidentiality via a written statement prohibiting
disclosure of their private information. House Bill 2139 has so far failed to receive a vote from any legislative committee, but it has until Feb. 16 to be heard.

Expanding the parental oversight of minors has been a frequently championed goal of Republican lawmakers in recent years.

In 2010, the legislature passed the
Parent’s Bill of Rights Act, cementing parental authority over the
health care, educational and religious lives of their children. Since
then, Republican lawmakers have used the act to bolster culture war
issues, such as by opening up every school library book to parental review and barring the state from requiring COVID-19 vaccinations to enroll in school.

What children share with trusted
adults who aren’t their parents has been a particular sore point for GOP
lawmakers, who in 2022 unsuccessfully attempted to mandate that teachers inform parents of their child’s gender identity.

Republicans justify intruding into
the privacy of minors by framing it as a necessary protection for those
who are still too young to make critical decisions for themselves.

“Teenagers take as much time as
toddlers. We as adults need to be engaged with our children,” said Rep.
Selina Bliss, R-Prescott, during a Monday debate of a different bill
increasing the medical records parents can review to include those for which parental consent isn’t required.

“Let’s not separate our children from the adult — the parent — by separating them from their medical records,” Bliss added.

But the problem with violating the
trust between health care providers and their minor patients is that it
will result in children turning away from experts in favor of less
reliable sources, said Darrell Hill, the policy director for the Arizona
branch of the ACLU.

“If we remove the ability of teens to
talk to physicians or other health providers in a confidential manner,
that doesn’t mean they’re going to go to their parents,” he said. “That
means they’re going to go to other teens or the internet, which are not
great sources of information.”

And while the proposal advises
providers to inform minors that their records will be subject to
disclosure without a signed prohibition, that leaves it up to providers
to decide when to issue the warning — and children already stressed out
may not fully understand what their rights are. Instead of complicating
the patient-provider relationship, parents should seek to establish
healthy communication with their children, Hill said.

“Parents want to know as much as they
can about their minors’ health and well-being. The best way to do that
is to have an open dialogue with your minor,” he said.

Multiple laws already exist that
preserve the parental role in a minor’s medical treatment. State law
requires parental consent before a surgical procedure or mental health treatment
is provided, unless the physician deems it an emergency. Doctors who
violate those rules face a class 1 misdemeanor, which carries with it a
maximum sentence of 6 months in jail.

And the Parent’s Bill of Rights
empowers parents to request, access and review all written and
electronic medical records pertaining to their child unless the parent
is being investigated for committing a crime against that child.

The health care that minors in Arizona can receive without a parent’s approval is limited. At 13, minors can access sexual and reproductive health care,
including pregnancy testing, STD treatment and birth control without
their parent’s permission. But, Hill warned, forcing doctors to share
what kinds of care their minor patients request would decrease the
willingness of those minors to access medical treatment, putting them at
risk of dangerous health outcomes.

“It makes it so those services are
presumptively open to seek information about — making it less likely
that teens who are at risk for serious medical issues won’t receive
treatment,” he said.

And, Hill added, it’s likely that the bill would run afoul of federal protections for medical confidentiality. The Health Insurance Portability and Accountability Act of 1996,
known commonly as HIPAA, protects the private health care information
of patients from unwarranted disclosure without their consent or

However, HIPAA also regards parents as representatives for their children, and gives them access to their child’s medical information, though mental health providers are allowed to refuse sharing a minor patient’s information if they have concerns about abuse or endangerment.