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Michigan law allows youth to get some medical care without their parents’ consent — limited mental health care or pregnancy tests, for example
A Republican lawmaker said parents must have full access to their child’s records to properly advocate for their care
Some doctors counter that youth in some circumstances must be able to confide in their providers — about abuse or questions about sexual health — without fear of their parents interference
A proposed Michigan law would allow parents full access to their children’s medical records, but some worry it would upend protections for young people needing to speak to doctors privately.
As it stands now, Michigan residents under age 18 may access medical treatment in certain circumstances without parental consent — substance use disorder treatment, tests for sexually transmitted infections or pregnancy tests. And Michigan youth 14 and older can seek some limited, outpatient mental health care without their parents’ knowledge, according to the Minnesota-based Network for Public Health Law.
Michigan children currently need a parent’s permission for abortions, vaccines, antidepressants and inpatient mental health treatment.
“These are children that we’ve, as a society, said ‘You’re too immature, too inexperienced to vote. You can’t go out and get a mortgage or a car loan. You can’t enlist in the military.’ You can’t …. get a tattoo unless your parent’s there, right?” State Rep. Joe Aragona, R- Clinton Township, the sponsor of the bill, said at a hearing last week.
“How much more important are these medical decisions?” he said.
Related:
State Rep. Joe Aragona, R-Clinton Township, said he’s willing to field suggestions from doctors’ associations concerned about his legislation. (Courtesy of Joe Aragona’s office)
Aragona’s bill is part of a growing debate nationally about where parents’ rights end as children age into adulthood. In the 1950s, states began allowing minors to seek medical treatment — without their parents — for a narrow slice of conditions, notably treatment for mental sexual health, including gender-affirming care. But a pushback began in 2023, with several states limiting that care, including Montana, Tennessee and Idaho, according to a review of laws published in April by the peer-reviewed Journal of the American Medical Association.
Lawmakers in North Carolina and Ohio last year proposed bills that were similar to Aragona’s, though both ultimately failed. And in Michigan, gubernatorial candidate John James, for example, has released what he calls a “bill of rights” for Michigan parents, claiming that “Lansing politicians want to erode your authority as parents.”
In Michigan, policies might vary from provider to provider.
Neither the Michigan Primary Care Association, which represents hundreds of community health center sites, nor the Michigan Health & Hospital Association offers guidance on parental access to records, although spokesperson Elise Gonzales said the organization is “currently working” toward a task force that would recommend best practices.
Meanwhile, the Michigan Chapter of the American Academy of Pediatricians has not taken a position on the new bill.
But this seems clear: Parents can be caught unaware.
“Often, parents are surprised by this — one day they can see everything and the next day they can’t,” Dr. Sharon Kileny, a pediatrician and clinical assistant professor at Michigan Medicine, said in a Michigan Medicine webpage from 2021 that cited state confidentiality laws for its policy that, at the time, limited parental access to their children’s medical records once they turn 11.
“Sometimes, we get phone calls from parents wondering what happened or why they can’t see anything anymore,” Kileny is quoted as saying.
Michigan Medicine has since changed its policy, boosting the age at which they begin limiting information to 13, according to an email from spokesperson Jina Sawani.
‘An unfathomable violation’
But unfettered parental access could force “an unfathomable violation of core health care privacy and protection,” said Alex Plum, CEO of The Corner Health Center in Ypsilanti, which provides care for patients 12 to 25 years old and their children.
Clinicians encourage young patients to involve their parents — going so far as to help their young patients plan out the best ways to approach their parents, Plum said.
“The goal is always to involve the parent,” he said. “That’s what we’re coached to do. That’s our expectation and that’s our best practice.”
But youth also must be able to confide in their doctor, he said. If not, some may forgo critical treatment.
And in rare cases, parental access could endanger a child who confides in a clinician, he said.
A youth recently arrived at the clinic for treatment for HIV after being sexually abused at home. In that case, a parents’ knowledge would have further endangered the child, Plum said.
Because treatment is often covered by adolescent health grants rather than parents’ insurance, a young patient can feel safe speaking to a clinician, he said.
Likewise, clinicians may extend reproductive care, paid for by federal Title X funds, to minors without parental consent, although a Texas court case has challenged that. (Title X does not fund abortions.) And Michigan law reinforces the ability of a minor to obtain reproductive health care without parental consent.
“We want to make sure that in those rare situations, a person in the health care system can be an advocate and ally to these young people who do not have one in their family,” he said.
Barb Flis, founder of South Lyon-based Parent Action for Healthy Kids, which works with schools and families on health and other issues, agreed.
Key to a child’s physical and mental well-being is being open for their questions, she said.
“I would advise parents against trying to fix something that’s not broken here,” she said. “The relationship with your child and being an ‘askable’ parent is the most important thing you can do, along with encouraging them to advocate for their good health care.”
A ‘Mama Bear law’
Maria D’Agostini Lukosavich, of Oakland Township, brought the issue to Aragona after a routine doctor’s visit with her then-12-year-old daughter.
The doctor asked the child to sign a consent form allowing her mother access to future medical records. D’Agostini Lukosavich said she was shocked.
A pre-teen’s brain isn’t yet fully developed, and youth may cut off parental access to their health care records for little reason other than they can, she said.
“I call it the Mama Bear Law,” D’Agostini Lukosavich said. “In my mind, parental rights are some of the most sacred rights, and there better be a damned good reason for them to be compromised,” she said.
D’Agostini Lukosavich said existing law also provides pathways for a physician to keep records from parents if he or she feels a young patient is in danger.
“Let the doctor raise a red flag if there’s a concern,” she said.
A doctor should sit with both parent and child during conversations about reproductive health, too, as a way to “foster healthy conversations” rather than “create public policy that divides the family.”
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